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 $15.14 Median $25.70 Typical High $66.07 | Facility | None | $15.14 | $25.70 | $66.07 |
Aetna Setting Professional Modifier None Typical Low $15.14 Median $25.70 Typical High $39.81 | Professional | None | $15.14 | $25.70 | $39.81 |
Ambetter Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | None | $30.20 | $30.20 | $30.20 |
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 $15.49 Median $38.90 Typical High $50.12 | Professional | None | $15.49 | $38.90 | $50.12 |
CareSource Setting Facility Modifier None Typical Low $16.60 Median $22.91 Typical High $29.51 | Facility | None | $16.60 | $22.91 | $29.51 |
CareSource Setting Professional Modifier None Typical Low $16.22 Median $22.39 Typical High $27.54 | Professional | None | $16.22 | $22.39 | $27.54 |
Cigna Setting Facility Modifier None Typical Low $19.95 Median $27.54 Typical High $53.70 | Facility | None | $19.95 | $27.54 | $53.70 |
Cigna Setting Professional Modifier None Typical Low $17.38 Median $35.48 Typical High $346.74 | Professional | None | $17.38 | $35.48 | $346.74 |
Molina Setting Professional Modifier None Typical Low $18.62 Median $33.11 Typical High $33.11 | Professional | None | $18.62 | $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 $26.92 Median $46.77 Typical High $67.61 | Professional | None | $26.92 | $46.77 | $67.61 |
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 $7.59 Median $12.88 Typical High $33.11 | Facility | 52 · Reduced service | $7.59 | $12.88 | $33.11 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $3.02 Median $5.25 Typical High $13.18 | Facility | 53 · Discontinued | $3.02 | $5.25 | $13.18 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $2.29 Median $3.89 Typical High $10.00 | Facility | 55 · Aftercare only | $2.29 | $3.89 | $10.00 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $1.51 Median $2.57 Typical High $6.61 | Facility | 56 · Pre-op care only | $1.51 | $2.57 | $6.61 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $7.59 Median $12.88 Typical High $16.22 | Professional | 52 · Reduced service | $7.59 | $12.88 | $16.22 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.02 Median $5.25 Typical High $6.46 | Professional | 53 · Discontinued | $3.02 | $5.25 | $6.46 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.29 Median $3.89 Typical High $4.79 | Professional | 55 · Aftercare only | $2.29 | $3.89 | $4.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.51 Median $2.57 Typical High $3.24 | Professional | 56 · Pre-op care only | $1.51 | $2.57 | $3.24 |
Where Kentucky sits
The same service costs 3.5 times more in Alaska than in Virginia. 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· 25th of 51
$38.90
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.