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 $776.25 Median $1,047.13 Typical High $1,122.02 | Facility | None | $776.25 | $1,047.13 | $1,122.02 |
Aetna Setting Professional Modifier None Typical Low $776.25 Median $851.14 Typical High $1,122.02 | Professional | None | $776.25 | $851.14 | $1,122.02 |
Anthem BCBS Setting Facility Modifier None Typical Low $758.58 Median $5,888.44 Typical High $11,220.18 | Facility | None | $758.58 | $5,888.44 | $11,220.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $645.65 Median $758.58 Typical High $1,000.00 | Professional | None | $645.65 | $758.58 | $1,000.00 |
CareSource Setting Facility Modifier None Typical Low $602.56 Median $724.44 Typical High $1,122.02 | Facility | None | $602.56 | $724.44 | $1,122.02 |
CareSource Setting Professional Modifier None Typical Low $707.95 Median $1,000.00 Typical High $1,174.90 | Professional | None | $707.95 | $1,000.00 | $1,174.90 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $691.83 Typical High $1,258.93 | Facility | None | $34.67 | $691.83 | $1,258.93 |
Cigna Setting Professional Modifier None Typical Low $724.44 Median $1,412.54 Typical High $3,388.44 | Professional | None | $724.44 | $1,412.54 | $3,388.44 |
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 $912.01 Median $1,230.27 Typical High $1,584.89 | Professional | None | $912.01 | $1,230.27 | $1,584.89 |
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 $389.05 Median $426.58 Typical High $562.34 | Professional | 52 · Reduced service | $389.05 | $426.58 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $169.82 Typical High $229.09 | Professional | 53 · Discontinued | $154.88 | $169.82 | $229.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $645.65 Typical High $851.14 | Professional | 54 · Surgery only | $588.84 | $645.65 | $851.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $128.82 Typical High $169.82 | Professional | 55 · Aftercare only | $117.49 | $128.82 | $169.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $85.11 Typical High $112.20 | Professional | 56 · Pre-op care only | $77.62 | $85.11 | $112.20 |
Where Kentucky sits
The same service costs 3.8 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· 50th of 51
$832
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.