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 $8.91 Median $17.38 Typical High $46.77 | Facility | None | $8.91 | $17.38 | $46.77 |
Aetna Setting Professional Modifier None Typical Low $8.91 Median $17.38 Typical High $26.92 | Professional | None | $8.91 | $17.38 | $26.92 |
Anthem BCBS Setting Facility Modifier None Typical Low $758.58 Median $9,549.93 Typical High $11,220.18 | Facility | None | $758.58 | $9,549.93 | $11,220.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $7.76 Median $13.80 Typical High $36.31 | Professional | None | $7.76 | $13.80 | $36.31 |
CareSource Setting Facility Modifier None Typical Low $7.94 Median $562.34 Typical High $933.25 | Facility | None | $7.94 | $562.34 | $933.25 |
CareSource Setting Professional Modifier None Typical Low $7.94 Median $11.22 Typical High $13.49 | Professional | None | $7.94 | $11.22 | $13.49 |
Cigna Setting Facility Modifier None Typical Low $13.80 Median $13.80 Typical High $13.80 | Facility | None | $13.80 | $13.80 | $13.80 |
Cigna Setting Professional Modifier None Typical Low $8.32 Median $23.44 Typical High $251.19 | Professional | None | $8.32 | $23.44 | $251.19 |
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 Professional Modifier None Typical Low $11.22 Median $17.78 Typical High $30.90 | Professional | None | $11.22 | $17.78 | $30.90 |
8 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 $4.47 Median $8.71 Typical High $23.44 | Facility | 52 · Reduced service | $4.47 | $8.71 | $23.44 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $1.78 Median $3.47 Typical High $9.33 | Facility | 53 · Discontinued | $1.78 | $3.47 | $9.33 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $1.35 Median $2.57 Typical High $7.08 | Facility | 55 · Aftercare only | $1.35 | $2.57 | $7.08 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $0.89 Median $1.74 Typical High $4.68 | Facility | 56 · Pre-op care only | $0.89 | $1.74 | $4.68 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $4.47 Median $8.71 Typical High $13.80 | Professional | 52 · Reduced service | $4.47 | $8.71 | $13.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.78 Median $3.47 Typical High $5.50 | Professional | 53 · Discontinued | $1.78 | $3.47 | $5.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.35 Median $2.57 Typical High $4.07 | Professional | 55 · Aftercare only | $1.35 | $2.57 | $4.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.89 Median $1.74 Typical High $2.75 | Professional | 56 · Pre-op care only | $0.89 | $1.74 | $2.75 |
Where Kentucky sits
The same service costs 3.2 times more in Wisconsin than in Nebraska. 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
$14.79
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.