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 $74.13 Median $104.71 Typical High $131.83 | Facility | None | $74.13 | $104.71 | $131.83 |
Aetna Setting Professional Modifier None Typical Low $74.13 Median $104.71 Typical High $131.83 | Professional | None | $74.13 | $104.71 | $131.83 |
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 $69.18 Median $83.18 Typical High $109.65 | Professional | None | $69.18 | $83.18 | $109.65 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $104.71 Median $123.03 Typical High $162.18 | Professional | 50 · Both sides | $104.71 | $123.03 | $162.18 |
CareSource Setting Facility Modifier None Typical Low $77.62 Median $104.71 Typical High $134.90 | Facility | None | $77.62 | $104.71 | $134.90 |
CareSource Setting Professional Modifier None Typical Low $81.28 Median $104.71 Typical High $131.83 | Professional | None | $81.28 | $104.71 | $131.83 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $107.15 Typical High $141.25 | Facility | None | $34.67 | $107.15 | $141.25 |
Cigna Setting Professional Modifier None Typical Low $83.18 Median $120.23 Typical High $676.08 | Professional | None | $83.18 | $120.23 | $676.08 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $50.12 | Professional | None | $33.11 | $33.11 | $50.12 |
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 $85.11 Median $120.23 Typical High $177.83 | Professional | None | $85.11 | $120.23 | $177.83 |
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 $37.15 Median $52.48 Typical High $64.57 | Facility | 52 · Reduced service | $37.15 | $52.48 | $64.57 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $14.79 Median $20.89 Typical High $26.30 | Facility | 53 · Discontinued | $14.79 | $20.89 | $26.30 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $11.22 Median $15.85 Typical High $19.50 | Facility | 55 · Aftercare only | $11.22 | $15.85 | $19.50 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $7.41 Median $10.47 Typical High $13.18 | Facility | 56 · Pre-op care only | $7.41 | $10.47 | $13.18 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $37.15 Median $52.48 Typical High $64.57 | Professional | 52 · Reduced service | $37.15 | $52.48 | $64.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.79 Median $20.89 Typical High $26.30 | Professional | 53 · Discontinued | $14.79 | $20.89 | $26.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $15.85 Typical High $19.50 | Professional | 55 · Aftercare only | $11.22 | $15.85 | $19.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $10.47 Typical High $13.18 | Professional | 56 · Pre-op care only | $7.41 | $10.47 | $13.18 |
Where Kentucky sits
The same service costs 3.6 times more in Alaska than in Maryland. 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· 50th of 51
$97.72
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.