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 $467.74 Median $630.96 Typical High $794.33 | Facility | None | $467.74 | $630.96 | $794.33 |
Aetna Setting Professional Modifier None Typical Low $467.74 Median $512.86 Typical High $724.44 | Professional | None | $467.74 | $512.86 | $724.44 |
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 $398.11 Median $489.78 Typical High $616.60 | Professional | None | $398.11 | $489.78 | $616.60 |
CareSource Setting Facility Modifier None Typical Low $363.08 Median $436.52 Typical High $676.08 | Facility | None | $363.08 | $436.52 | $676.08 |
CareSource Setting Professional Modifier None Typical Low $467.74 Median $588.84 Typical High $707.95 | Professional | None | $467.74 | $588.84 | $707.95 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $512.86 Typical High $794.33 | Facility | None | $34.67 | $512.86 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $436.52 Median $831.76 Typical High $2,137.96 | Professional | None | $436.52 | $831.76 | $2,137.96 |
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 $588.84 Median $776.25 Typical High $954.99 | Professional | None | $588.84 | $776.25 | $954.99 |
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 $234.42 Median $257.04 Typical High $363.08 | Professional | 52 · Reduced service | $234.42 | $257.04 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $102.33 Typical High $144.54 | Professional | 53 · Discontinued | $93.33 | $102.33 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $346.74 Median $389.05 Typical High $549.54 | Professional | 54 · Surgery only | $346.74 | $389.05 | $549.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $77.62 Typical High $109.65 | Professional | 55 · Aftercare only | $70.79 | $77.62 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $51.29 Typical High $72.44 | Professional | 56 · Pre-op care only | $46.77 | $51.29 | $72.44 |
Where Kentucky sits
The same service costs 3.9 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· 47th of 51
$550
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.