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 $75.86 Median $77.62 Typical High $3,801.89 | Facility | None | $75.86 | $77.62 | $3,801.89 |
Aetna Setting Professional Modifier None Typical Low $75.86 Median $77.62 Typical High $117.49 | Professional | None | $75.86 | $77.62 | $117.49 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,737.80 Median $2,951.21 Typical High $9,120.11 | Facility | None | $1,737.80 | $2,951.21 | $9,120.11 |
Anthem BCBS Setting Professional Modifier None Typical Low $66.07 Median $102.33 Typical High $154.88 | Professional | None | $66.07 | $102.33 | $154.88 |
CareSource Setting Facility Modifier None Typical Low $61.66 Median $74.13 Typical High $117.49 | Facility | None | $61.66 | $74.13 | $117.49 |
CareSource Setting Professional Modifier None Typical Low $72.44 Median $102.33 Typical High $120.23 | Professional | None | $72.44 | $102.33 | $120.23 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $125.89 Typical High $691.83 | Facility | None | $34.67 | $125.89 | $691.83 |
Cigna Setting Professional Modifier None Typical Low $74.13 Median $128.82 Typical High $616.60 | Professional | None | $74.13 | $128.82 | $616.60 |
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 $354.81 Median $912.01 Typical High $8,317.64 | Facility | None | $354.81 | $912.01 | $8,317.64 |
United Setting Professional Modifier None Typical Low $83.18 Median $120.23 Typical High $158.49 | Professional | None | $83.18 | $120.23 | $158.49 |
5 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 Professional Modifier 52 · Reduced service Typical Low $38.02 Median $38.90 Typical High $48.98 | Professional | 52 · Reduced service | $38.02 | $38.90 | $48.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.14 Median $15.49 Typical High $19.95 | Professional | 53 · Discontinued | $15.14 | $15.49 | $19.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $57.54 Median $57.54 Typical High $74.13 | Professional | 54 · Surgery only | $57.54 | $57.54 | $74.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.48 Median $11.75 Typical High $14.79 | Professional | 55 · Aftercare only | $11.48 | $11.75 | $14.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $7.76 Typical High $10.00 | Professional | 56 · Pre-op care only | $7.59 | $7.76 | $10.00 |
Where Kentucky sits
The same service costs 6.5 times more in Tennessee than in New York. 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· 46th of 51
$102
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.