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 $45.71 Median $64.57 Typical High $95.50 | Facility | None | $45.71 | $64.57 | $95.50 |
Aetna Setting Professional Modifier None Typical Low $45.71 Median $64.57 Typical High $91.20 | Professional | None | $45.71 | $64.57 | $91.20 |
Ambetter Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $117.49 | Professional | None | $72.44 | $72.44 | $117.49 |
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 $46.77 Median $63.10 Typical High $89.13 | Professional | None | $46.77 | $63.10 | $89.13 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $70.79 Median $95.50 Typical High $134.90 | Professional | 50 · Both sides | $70.79 | $95.50 | $134.90 |
CareSource Setting Facility Modifier None Typical Low $42.66 Median $61.66 Typical High $79.43 | Facility | None | $42.66 | $61.66 | $79.43 |
CareSource Setting Professional Modifier None Typical Low $45.71 Median $67.61 Typical High $83.18 | Professional | None | $45.71 | $67.61 | $83.18 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $60.26 Typical High $89.13 | Facility | None | $34.67 | $60.26 | $89.13 |
Cigna Setting Professional Modifier None Typical Low $51.29 Median $79.43 Typical High $501.19 | Professional | None | $51.29 | $79.43 | $501.19 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $47.86 | Professional | None | $33.11 | $33.11 | $47.86 |
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 $64.57 Median $89.13 Typical High $131.83 | Professional | None | $64.57 | $89.13 | $131.83 |
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 $22.91 Median $32.36 Typical High $47.86 | Facility | 52 · Reduced service | $22.91 | $32.36 | $47.86 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $9.12 Median $12.88 Typical High $19.05 | Facility | 53 · Discontinued | $9.12 | $12.88 | $19.05 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $6.92 Median $9.55 Typical High $14.13 | Facility | 55 · Aftercare only | $6.92 | $9.55 | $14.13 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $4.57 Median $6.46 Typical High $9.55 | Facility | 56 · Pre-op care only | $4.57 | $6.46 | $9.55 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $22.91 Median $32.36 Typical High $39.81 | Professional | 52 · Reduced service | $22.91 | $32.36 | $39.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.12 Median $12.88 Typical High $15.85 | Professional | 53 · Discontinued | $9.12 | $12.88 | $15.85 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.92 Median $9.55 Typical High $12.02 | Professional | 55 · Aftercare only | $6.92 | $9.55 | $12.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.57 Median $6.46 Typical High $7.94 | Professional | 56 · Pre-op care only | $4.57 | $6.46 | $7.94 |
Where Kentucky sits
The same service costs 3.5 times more in Alaska than in Florida. 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· 47th of 51
$70.79
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.