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 $15.85 Median $28.18 Typical High $63.10 | Facility | None | $15.85 | $28.18 | $63.10 |
Aetna Setting Professional Modifier None Typical Low $15.85 Median $28.18 Typical High $38.90 | Professional | None | $15.85 | $28.18 | $38.90 |
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 $36.31 Typical High $47.86 | Professional | None | $15.49 | $36.31 | $47.86 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $23.44 Median $53.70 Typical High $70.79 | Professional | 50 · Both sides | $23.44 | $53.70 | $70.79 |
CareSource Setting Facility Modifier None Typical Low $16.98 Median $562.34 Typical High $933.25 | Facility | None | $16.98 | $562.34 | $933.25 |
CareSource Setting Professional Modifier None Typical Low $18.62 Median $23.44 Typical High $28.18 | Professional | None | $18.62 | $23.44 | $28.18 |
Cigna Setting Facility Modifier None Typical Low $27.54 Median $34.67 Typical High $75.86 | Facility | None | $27.54 | $34.67 | $75.86 |
Cigna Setting Professional Modifier None Typical Low $17.38 Median $34.67 Typical High $338.84 | Professional | None | $17.38 | $34.67 | $338.84 |
Molina Setting Professional Modifier None Typical Low $22.39 Median $33.11 Typical High $33.11 | Professional | None | $22.39 | $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 $27.54 Median $44.67 Typical High $66.07 | Professional | None | $27.54 | $44.67 | $66.07 |
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 $7.94 Median $14.13 Typical High $31.62 | Facility | 52 · Reduced service | $7.94 | $14.13 | $31.62 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $3.16 Median $5.62 Typical High $12.59 | Facility | 53 · Discontinued | $3.16 | $5.62 | $12.59 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $2.34 Median $4.27 Typical High $9.55 | Facility | 55 · Aftercare only | $2.34 | $4.27 | $9.55 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $1.58 Median $2.82 Typical High $6.31 | Facility | 56 · Pre-op care only | $1.58 | $2.82 | $6.31 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $7.94 Median $13.80 Typical High $17.38 | Professional | 52 · Reduced service | $7.94 | $13.80 | $17.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.16 Median $5.50 Typical High $7.08 | Professional | 53 · Discontinued | $3.16 | $5.50 | $7.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.34 Median $4.17 Typical High $5.25 | Professional | 55 · Aftercare only | $2.34 | $4.17 | $5.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.58 Median $2.75 Typical High $3.55 | Professional | 56 · Pre-op care only | $1.58 | $2.75 | $3.55 |
Where Kentucky sits
The same service costs 3.8 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· 34th of 51
$36.31
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.