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 $66.07 Median $91.20 Typical High $112.20 | Facility | None | $66.07 | $91.20 | $112.20 |
Aetna Setting Professional Modifier None Typical Low $66.07 Median $89.13 Typical High $112.20 | Professional | None | $66.07 | $89.13 | $112.20 |
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 $57.54 Median $75.86 Typical High $102.33 | Professional | None | $57.54 | $75.86 | $102.33 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $87.10 Median $114.82 Typical High $151.36 | Professional | 50 · Both sides | $87.10 | $114.82 | $151.36 |
CareSource Setting Facility Modifier None Typical Low $69.18 Median $79.43 Typical High $114.82 | Facility | None | $69.18 | $79.43 | $114.82 |
CareSource Setting Professional Modifier None Typical Low $70.79 Median $95.50 Typical High $117.49 | Professional | None | $70.79 | $95.50 | $117.49 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $81.28 Typical High $120.23 | Facility | None | $34.67 | $81.28 | $120.23 |
Cigna Setting Professional Modifier None Typical Low $72.44 Median $100.00 Typical High $575.44 | Professional | None | $72.44 | $100.00 | $575.44 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $45.71 | Professional | None | $33.11 | $33.11 | $45.71 |
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 $75.86 Median $104.71 Typical High $154.88 | Professional | None | $75.86 | $104.71 | $154.88 |
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 $32.36 Median $45.71 Typical High $56.23 | Facility | 52 · Reduced service | $32.36 | $45.71 | $56.23 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $13.18 Median $18.20 Typical High $22.39 | Facility | 53 · Discontinued | $13.18 | $18.20 | $22.39 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $9.77 Median $13.80 Typical High $16.98 | Facility | 55 · Aftercare only | $9.77 | $13.80 | $16.98 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $6.61 Median $9.12 Typical High $11.22 | Facility | 56 · Pre-op care only | $6.61 | $9.12 | $11.22 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $32.36 Median $44.67 Typical High $56.23 | Professional | 52 · Reduced service | $32.36 | $44.67 | $56.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.18 Median $17.78 Typical High $22.39 | Professional | 53 · Discontinued | $13.18 | $17.78 | $22.39 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.77 Median $13.49 Typical High $16.98 | Professional | 55 · Aftercare only | $9.77 | $13.49 | $16.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.61 Median $8.91 Typical High $11.22 | Professional | 56 · Pre-op care only | $6.61 | $8.91 | $11.22 |
Where Kentucky sits
The same service costs 3.8 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
$87.10
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.