How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $33.88 Median $60.26 Typical High $91.20 | Facility | None | $33.88 | $60.26 | $91.20 |
Aetna Setting Professional Modifier None Typical Low $33.88 Median $56.23 Typical High $89.13 | Professional | None | $33.88 | $56.23 | $89.13 |
Ambetter Setting Professional Modifier None Typical Low $40.74 Median $61.66 Typical High $79.43 | Professional | None | $40.74 | $61.66 | $79.43 |
Anthem BCBS Setting Facility Modifier None Typical Low $575.44 Median $3,801.89 Typical High $11,220.18 | Facility | None | $575.44 | $3,801.89 | $11,220.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $32.36 Median $38.90 Typical High $54.95 | Professional | None | $32.36 | $38.90 | $54.95 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $47.86 Median $57.54 Typical High $81.28 | Professional | 50 · Both sides | $47.86 | $57.54 | $81.28 |
CareSource Setting Facility Modifier None Typical Low $36.31 Median $524.81 Typical High $933.25 | Facility | None | $36.31 | $524.81 | $933.25 |
CareSource Setting Professional Modifier None Typical Low $51.29 Median $63.10 Typical High $87.10 | Professional | None | $51.29 | $63.10 | $87.10 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $70.79 Typical High $75.86 | Facility | None | $34.67 | $70.79 | $75.86 |
Cigna Setting Professional Modifier None Typical Low $38.02 Median $61.66 Typical High $380.19 | Professional | None | $38.02 | $61.66 | $380.19 |
Molina Setting Professional Modifier None Typical Low $23.44 Median $33.11 Typical High $33.11 | Professional | None | $23.44 | $33.11 | $33.11 |
United Setting Facility Modifier None Typical Low $70.79 Median $186.21 Typical High $1,148.15 | Facility | None | $70.79 | $186.21 | $1,148.15 |
United Setting Professional Modifier None Typical Low $40.74 Median $61.66 Typical High $93.33 | Professional | None | $40.74 | $61.66 | $93.33 |
8 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier 52 · Reduced service Typical Low $16.98 Median $28.18 Typical High $34.67 | Facility | 52 · Reduced service | $16.98 | $28.18 | $34.67 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $6.76 Median $11.22 Typical High $13.80 | Facility | 53 · Discontinued | $6.76 | $11.22 | $13.80 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $5.13 Median $8.51 Typical High $10.47 | Facility | 55 · Aftercare only | $5.13 | $8.51 | $10.47 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $3.39 Median $5.62 Typical High $6.92 | Facility | 56 · Pre-op care only | $3.39 | $5.62 | $6.92 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $16.98 Median $27.54 Typical High $34.67 | Professional | 52 · Reduced service | $16.98 | $27.54 | $34.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.76 Median $10.96 Typical High $13.80 | Professional | 53 · Discontinued | $6.76 | $10.96 | $13.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.13 Median $8.32 Typical High $10.47 | Professional | 55 · Aftercare only | $5.13 | $8.32 | $10.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.39 Median $5.50 Typical High $6.92 | Professional | 56 · Pre-op care only | $3.39 | $5.50 | $6.92 |
Where Kentucky sits
The same service costs 4.0 times more in Alaska than in Kentucky. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Kentucky· 51st of 51
$48.98
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.