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 $13.49 Median $19.50 Typical High $81.28 | Facility | None | $13.49 | $19.50 | $81.28 |
Aetna Setting Professional Modifier None Typical Low $13.49 Median $26.30 Typical High $77.62 | Professional | None | $13.49 | $26.30 | $77.62 |
Ambetter Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $89.13 | Professional | None | $89.13 | $89.13 | $89.13 |
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 $12.59 Median $14.79 Typical High $21.88 | Professional | None | $12.59 | $14.79 | $21.88 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $19.05 Median $22.39 Typical High $33.11 | Professional | 50 · Both sides | $19.05 | $22.39 | $33.11 |
CareSource Setting Facility Modifier None Typical Low $14.79 Median $23.44 Typical High $107.15 | Facility | None | $14.79 | $23.44 | $107.15 |
CareSource Setting Professional Modifier None Typical Low $15.85 Median $19.95 Typical High $24.55 | Professional | None | $15.85 | $19.95 | $24.55 |
Cigna Setting Facility Modifier None Typical Low $23.99 Median $66.07 Typical High $75.86 | Facility | None | $23.99 | $66.07 | $75.86 |
Cigna Setting Professional Modifier None Typical Low $14.79 Median $70.79 Typical High $363.08 | Professional | None | $14.79 | $70.79 | $363.08 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $41.69 | Professional | None | $33.11 | $33.11 | $41.69 |
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 $16.98 Median $60.26 Typical High $117.49 | Professional | None | $16.98 | $60.26 | $117.49 |
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 $6.76 Median $9.55 Typical High $40.74 | Facility | 52 · Reduced service | $6.76 | $9.55 | $40.74 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $2.69 Median $3.89 Typical High $16.22 | Facility | 53 · Discontinued | $2.69 | $3.89 | $16.22 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $2.04 Median $2.88 Typical High $12.02 | Facility | 55 · Aftercare only | $2.04 | $2.88 | $12.02 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $1.35 Median $1.95 Typical High $8.13 | Facility | 56 · Pre-op care only | $1.35 | $1.95 | $8.13 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $6.76 Median $13.18 Typical High $38.90 | Professional | 52 · Reduced service | $6.76 | $13.18 | $38.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.69 Median $5.25 Typical High $15.49 | Professional | 53 · Discontinued | $2.69 | $5.25 | $15.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.04 Median $3.98 Typical High $11.48 | Professional | 55 · Aftercare only | $2.04 | $3.98 | $11.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.35 Median $2.63 Typical High $7.76 | Professional | 56 · Pre-op care only | $1.35 | $2.63 | $7.76 |
Where Kentucky sits
The same service costs 5.9 times more in Iowa 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
$19.95
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.