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 $29.51 Median $45.71 Typical High $57.54 | Facility | None | $29.51 | $45.71 | $57.54 |
Aetna Setting Professional Modifier None Typical Low $29.51 Median $45.71 Typical High $57.54 | Professional | None | $29.51 | $45.71 | $57.54 |
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 $26.30 Median $31.62 Typical High $48.98 | Professional | None | $26.30 | $31.62 | $48.98 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $39.81 Median $47.86 Typical High $72.44 | Professional | 50 · Both sides | $39.81 | $47.86 | $72.44 |
CareSource Setting Facility Modifier None Typical Low $31.62 Median $524.81 Typical High $933.25 | Facility | None | $31.62 | $524.81 | $933.25 |
CareSource Setting Professional Modifier None Typical Low $35.48 Median $43.65 Typical High $52.48 | Professional | None | $35.48 | $43.65 | $52.48 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $54.95 Typical High $75.86 | Facility | None | $34.67 | $54.95 | $75.86 |
Cigna Setting Professional Modifier None Typical Low $32.36 Median $50.12 Typical High $295.12 | Professional | None | $32.36 | $50.12 | $295.12 |
Molina Setting Professional Modifier None Typical Low $20.89 Median $33.11 Typical High $33.11 | Professional | None | $20.89 | $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 $33.11 Median $48.98 Typical High $72.44 | Professional | None | $33.11 | $48.98 | $72.44 |
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 $14.79 Median $22.91 Typical High $28.84 | Facility | 52 · Reduced service | $14.79 | $22.91 | $28.84 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $5.89 Median $9.33 Typical High $11.48 | Facility | 53 · Discontinued | $5.89 | $9.33 | $11.48 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $4.47 Median $6.92 Typical High $8.51 | Facility | 55 · Aftercare only | $4.47 | $6.92 | $8.51 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $2.95 Median $4.57 Typical High $5.75 | Facility | 56 · Pre-op care only | $2.95 | $4.57 | $5.75 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $14.79 Median $22.39 Typical High $28.84 | Professional | 52 · Reduced service | $14.79 | $22.39 | $28.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.89 Median $9.12 Typical High $11.48 | Professional | 53 · Discontinued | $5.89 | $9.12 | $11.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.47 Median $6.76 Typical High $8.51 | Professional | 55 · Aftercare only | $4.47 | $6.76 | $8.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.95 Median $4.47 Typical High $5.75 | Professional | 56 · Pre-op care only | $2.95 | $4.47 | $5.75 |
Where Kentucky sits
The same service costs 3.7 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
$39.81
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.