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 $38.02 Median $54.95 Typical High $67.61 | Facility | None | $38.02 | $54.95 | $67.61 |
Aetna Setting Professional Modifier None Typical Low $38.02 Median $52.48 Typical High $67.61 | Professional | None | $38.02 | $52.48 | $67.61 |
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 $37.15 Median $46.77 Typical High $63.10 | Professional | None | $37.15 | $46.77 | $63.10 |
CareSource Setting Facility Modifier None Typical Low $34.67 Median $46.77 Typical High $66.07 | Facility | None | $34.67 | $46.77 | $66.07 |
CareSource Setting Professional Modifier None Typical Low $40.74 Median $54.95 Typical High $67.61 | Professional | None | $40.74 | $54.95 | $67.61 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $46.77 Typical High $75.86 | Facility | None | $34.67 | $46.77 | $75.86 |
Cigna Setting Professional Modifier None Typical Low $42.66 Median $63.10 Typical High $354.81 | Professional | None | $42.66 | $63.10 | $354.81 |
Molina Setting Professional Modifier None Typical Low $27.54 Median $33.11 Typical High $33.11 | Professional | None | $27.54 | $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 $45.71 Median $64.57 Typical High $97.72 | Professional | None | $45.71 | $64.57 | $97.72 |
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 $19.05 Median $27.54 Typical High $33.88 | Facility | 52 · Reduced service | $19.05 | $27.54 | $33.88 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $7.59 Median $10.96 Typical High $13.49 | Facility | 53 · Discontinued | $7.59 | $10.96 | $13.49 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $5.62 Median $8.13 Typical High $10.23 | Facility | 55 · Aftercare only | $5.62 | $8.13 | $10.23 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $3.80 Median $5.50 Typical High $6.76 | Facility | 56 · Pre-op care only | $3.80 | $5.50 | $6.76 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $19.05 Median $27.54 Typical High $33.88 | Professional | 52 · Reduced service | $19.05 | $27.54 | $33.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.59 Median $10.96 Typical High $13.49 | Professional | 53 · Discontinued | $7.59 | $10.96 | $13.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.62 Median $8.13 Typical High $10.23 | Professional | 55 · Aftercare only | $5.62 | $8.13 | $10.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.80 Median $5.50 Typical High $6.76 | Professional | 56 · Pre-op care only | $3.80 | $5.50 | $6.76 |
Where Kentucky sits
The same service costs 3.5 times more in Alaska than in Florida. 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
$52.48
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.