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 $234.42 Median $316.23 Typical High $794.33 | Facility | None | $234.42 | $316.23 | $794.33 |
Aetna Setting Professional Modifier None Typical Low $234.42 Median $257.04 Typical High $363.08 | Professional | None | $234.42 | $257.04 | $363.08 |
Anthem BCBS Setting Facility Modifier None Typical Low $758.58 Median $5,011.87 Typical High $11,220.18 | Facility | None | $758.58 | $5,011.87 | $11,220.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $199.53 Median $275.42 Typical High $331.13 | Professional | None | $199.53 | $275.42 | $331.13 |
CareSource Setting Facility Modifier None Typical Low $181.97 Median $218.78 Typical High $338.84 | Facility | None | $181.97 | $218.78 | $338.84 |
CareSource Setting Professional Modifier None Typical Low $194.98 Median $302.00 Typical High $354.81 | Professional | None | $194.98 | $302.00 | $354.81 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $389.05 Typical High $794.33 | Facility | None | $34.67 | $389.05 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $218.78 Median $416.87 Typical High $1,071.52 | Professional | None | $218.78 | $416.87 | $1,071.52 |
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 $288.40 Median $389.05 Typical High $478.63 | Professional | None | $288.40 | $389.05 | $478.63 |
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 $117.49 Median $128.82 Typical High $181.97 | Professional | 52 · Reduced service | $117.49 | $128.82 | $181.97 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $46.77 Median $51.29 Typical High $72.44 | Professional | 53 · Discontinued | $46.77 | $51.29 | $72.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $194.98 Typical High $275.42 | Professional | 54 · Surgery only | $177.83 | $194.98 | $275.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $38.90 Typical High $54.95 | Professional | 55 · Aftercare only | $35.48 | $38.90 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $25.70 Typical High $36.31 | Professional | 56 · Pre-op care only | $23.44 | $25.70 | $36.31 |
Where Kentucky sits
The same service costs 4.0 times more in Wisconsin 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· 43rd of 51
$316
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.