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 $57.54 Median $89.13 Typical High $102.33 | Facility | None | $57.54 | $89.13 | $102.33 |
Aetna Setting Professional Modifier None Typical Low $57.54 Median $89.13 Typical High $125.89 | Professional | None | $57.54 | $89.13 | $125.89 |
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 $47.86 Median $56.23 Typical High $77.62 | Professional | None | $47.86 | $56.23 | $77.62 |
CareSource Setting Facility Modifier None Typical Low $53.70 Median $89.13 Typical High $128.82 | Facility | None | $53.70 | $89.13 | $128.82 |
CareSource Setting Professional Modifier None Typical Low $54.95 Median $77.62 Typical High $91.20 | Professional | None | $54.95 | $77.62 | $91.20 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $93.33 Typical High $398.11 | Facility | None | $34.67 | $93.33 | $398.11 |
Cigna Setting Professional Modifier None Typical Low $56.23 Median $100.00 Typical High $537.03 | Professional | None | $56.23 | $100.00 | $537.03 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $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 $58.88 Median $100.00 Typical High $158.49 | Professional | None | $58.88 | $100.00 | $158.49 |
10 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 $28.84 Median $43.65 Typical High $51.29 | Facility | 52 · Reduced service | $28.84 | $43.65 | $51.29 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $11.48 Median $17.78 Typical High $20.42 | Facility | 53 · Discontinued | $11.48 | $17.78 | $20.42 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $43.65 Median $66.07 Typical High $75.86 | Facility | 54 · Surgery only | $43.65 | $66.07 | $75.86 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $8.71 Median $13.18 Typical High $15.14 | Facility | 55 · Aftercare only | $8.71 | $13.18 | $15.14 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $5.75 Median $8.91 Typical High $10.23 | Facility | 56 · Pre-op care only | $5.75 | $8.91 | $10.23 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $28.84 Median $43.65 Typical High $52.48 | Professional | 52 · Reduced service | $28.84 | $43.65 | $52.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.48 Median $17.78 Typical High $21.38 | Professional | 53 · Discontinued | $11.48 | $17.78 | $21.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $43.65 Median $66.07 Typical High $79.43 | Professional | 54 · Surgery only | $43.65 | $66.07 | $79.43 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.71 Median $13.18 Typical High $15.85 | Professional | 55 · Aftercare only | $8.71 | $13.18 | $15.85 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.75 Median $8.91 Typical High $10.47 | Professional | 56 · Pre-op care only | $5.75 | $8.91 | $10.47 |
Where Kentucky sits
The same service costs 3.9 times more in Wisconsin 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
$64.57
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.