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 $70.79 Median $104.71 Typical High $128.82 | Facility | None | $70.79 | $104.71 | $128.82 |
Aetna Setting Professional Modifier None Typical Low $70.79 Median $102.33 Typical High $128.82 | Professional | None | $70.79 | $102.33 | $128.82 |
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 $69.18 Median $81.28 Typical High $117.49 | Professional | None | $69.18 | $81.28 | $117.49 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $102.33 Median $123.03 Typical High $173.78 | Professional | 50 · Both sides | $102.33 | $123.03 | $173.78 |
CareSource Setting Facility Modifier None Typical Low $74.13 Median $93.33 Typical High $123.03 | Facility | None | $74.13 | $93.33 | $123.03 |
CareSource Setting Professional Modifier None Typical Low $69.18 Median $102.33 Typical High $125.89 | Professional | None | $69.18 | $102.33 | $125.89 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $97.72 Typical High $128.82 | Facility | None | $34.67 | $97.72 | $128.82 |
Cigna Setting Professional Modifier None Typical Low $77.62 Median $117.49 Typical High $676.08 | Professional | None | $77.62 | $117.49 | $676.08 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $46.77 | Professional | None | $33.11 | $33.11 | $46.77 |
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 $81.28 Median $117.49 Typical High $173.78 | Professional | None | $81.28 | $117.49 | $173.78 |
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 $35.48 Median $52.48 Typical High $64.57 | Facility | 52 · Reduced service | $35.48 | $52.48 | $64.57 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $14.13 Median $20.89 Typical High $25.70 | Facility | 53 · Discontinued | $14.13 | $20.89 | $25.70 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $10.47 Median $15.85 Typical High $19.50 | Facility | 55 · Aftercare only | $10.47 | $15.85 | $19.50 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $7.08 Median $10.47 Typical High $12.88 | Facility | 56 · Pre-op care only | $7.08 | $10.47 | $12.88 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $35.48 Median $51.29 Typical High $64.57 | Professional | 52 · Reduced service | $35.48 | $51.29 | $64.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.13 Median $20.42 Typical High $25.70 | Professional | 53 · Discontinued | $14.13 | $20.42 | $25.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $15.49 Typical High $19.50 | Professional | 55 · Aftercare only | $10.47 | $15.49 | $19.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.08 Median $10.23 Typical High $12.88 | Professional | 56 · Pre-op care only | $7.08 | $10.23 | $12.88 |
Where Kentucky sits
The same service costs 3.5 times more in Alaska than in Maryland. 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· 49th of 51
$97.72
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.