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 $95.50 Median $123.03 Typical High $158.49 | Facility | None | $95.50 | $123.03 | $158.49 |
Aetna Setting Professional Modifier None Typical Low $95.50 Median $123.03 Typical High $154.88 | Professional | None | $95.50 | $123.03 | $154.88 |
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 $77.62 Median $91.20 Typical High $120.23 | Professional | None | $77.62 | $91.20 | $120.23 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $117.49 Median $138.04 Typical High $173.78 | Professional | 50 · Both sides | $117.49 | $138.04 | $173.78 |
CareSource Setting Facility Modifier None Typical Low $89.13 Median $104.71 Typical High $165.96 | Facility | None | $89.13 | $104.71 | $165.96 |
CareSource Setting Professional Modifier None Typical Low $104.71 Median $141.25 Typical High $169.82 | Professional | None | $104.71 | $141.25 | $169.82 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $81.28 Typical High $177.83 | Facility | None | $34.67 | $81.28 | $177.83 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $147.91 Typical High $831.76 | Professional | None | $107.15 | $147.91 | $831.76 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $37.15 | Professional | None | $33.11 | $33.11 | $37.15 |
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 $120.23 Median $154.88 Typical High $229.09 | Professional | None | $120.23 | $154.88 | $229.09 |
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 $47.86 Median $61.66 Typical High $79.43 | Facility | 52 · Reduced service | $47.86 | $61.66 | $79.43 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $19.05 Median $24.55 Typical High $31.62 | Facility | 53 · Discontinued | $19.05 | $24.55 | $31.62 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $14.45 Median $18.62 Typical High $23.44 | Facility | 55 · Aftercare only | $14.45 | $18.62 | $23.44 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $9.55 Median $12.30 Typical High $15.85 | Facility | 56 · Pre-op care only | $9.55 | $12.30 | $15.85 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $47.86 Median $61.66 Typical High $75.86 | Professional | 52 · Reduced service | $47.86 | $61.66 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.05 Median $24.55 Typical High $30.20 | Professional | 53 · Discontinued | $19.05 | $24.55 | $30.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.45 Median $18.62 Typical High $22.91 | Professional | 55 · Aftercare only | $14.45 | $18.62 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.55 Median $12.30 Typical High $15.14 | Professional | 56 · Pre-op care only | $9.55 | $12.30 | $15.14 |
Where Kentucky sits
The same service costs 4.3 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
$107
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.