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 $23.44 Typical High $41.69 | Facility | None | $15.14 | $23.44 | $41.69 |
Aetna Setting Professional Modifier None Typical Low $15.14 Median $23.44 Typical High $33.88 | Professional | None | $15.14 | $23.44 | $33.88 |
Ambetter Setting Professional Modifier None Typical Low $26.30 Median $26.30 Typical High $26.30 | Professional | None | $26.30 | $26.30 | $26.30 |
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 $15.14 Median $28.84 Typical High $41.69 | Professional | None | $15.14 | $28.84 | $41.69 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $22.91 Median $43.65 Typical High $63.10 | Professional | 50 · Both sides | $22.91 | $43.65 | $63.10 |
CareSource Setting Facility Modifier None Typical Low $16.22 Median $19.05 Typical High $26.30 | Facility | None | $16.22 | $19.05 | $26.30 |
CareSource Setting Professional Modifier None Typical Low $22.91 Median $26.30 Typical High $36.31 | Professional | None | $22.91 | $26.30 | $36.31 |
Cigna Setting Facility Modifier None Typical Low $15.85 Median $27.54 Typical High $53.70 | Facility | None | $15.85 | $27.54 | $53.70 |
Cigna Setting Professional Modifier None Typical Low $16.60 Median $29.51 Typical High $213.80 | Professional | None | $16.60 | $29.51 | $213.80 |
Molina Setting Professional Modifier None Typical Low $20.42 Median $33.11 Typical High $33.11 | Professional | None | $20.42 | $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 $23.99 Median $35.48 Typical High $52.48 | Professional | None | $23.99 | $35.48 | $52.48 |
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 $11.75 Typical High $20.42 | Facility | 52 · Reduced service | $7.59 | $11.75 | $20.42 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $3.02 Median $4.68 Typical High $8.32 | Facility | 53 · Discontinued | $3.02 | $4.68 | $8.32 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $2.24 Median $3.55 Typical High $6.17 | Facility | 55 · Aftercare only | $2.24 | $3.55 | $6.17 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $1.51 Median $2.34 Typical High $4.07 | Facility | 56 · Pre-op care only | $1.51 | $2.34 | $4.07 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $7.59 Median $11.75 Typical High $14.79 | Professional | 52 · Reduced service | $7.59 | $11.75 | $14.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.02 Median $4.68 Typical High $5.89 | Professional | 53 · Discontinued | $3.02 | $4.68 | $5.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.24 Median $3.55 Typical High $4.37 | Professional | 55 · Aftercare only | $2.24 | $3.55 | $4.37 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.51 Median $2.34 Typical High $2.95 | Professional | 56 · Pre-op care only | $1.51 | $2.34 | $2.95 |
Where Kentucky sits
The same service costs 3.0 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· 41st of 51
$28.84
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.