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 $9.33 Median $17.78 Typical High $28.84 | Facility | None | $9.33 | $17.78 | $28.84 |
Aetna Setting Professional Modifier None Typical Low $9.33 Median $17.78 Typical High $28.84 | Professional | None | $9.33 | $17.78 | $28.84 |
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 $32.36 | Professional | None | $7.76 | $13.80 | $32.36 |
CareSource Setting Facility Modifier None Typical Low $8.13 Median $524.81 Typical High $933.25 | Facility | None | $8.13 | $524.81 | $933.25 |
CareSource Setting Professional Modifier None Typical Low $10.00 Median $16.22 Typical High $22.91 | Professional | None | $10.00 | $16.22 | $22.91 |
Cigna Setting Facility Modifier None Typical Low $7.59 Median $14.45 Typical High $20.42 | Facility | None | $7.59 | $14.45 | $20.42 |
Cigna Setting Professional Modifier None Typical Low $8.71 Median $23.44 Typical High $154.88 | Professional | None | $8.71 | $23.44 | $154.88 |
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 $18.62 Typical High $32.36 | Professional | None | $11.22 | $18.62 | $32.36 |
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 $4.57 Median $8.91 Typical High $14.45 | Facility | 52 · Reduced service | $4.57 | $8.91 | $14.45 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $1.86 Median $3.55 Typical High $5.75 | Facility | 53 · Discontinued | $1.86 | $3.55 | $5.75 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $1.38 Median $2.63 Typical High $4.37 | Facility | 55 · Aftercare only | $1.38 | $2.63 | $4.37 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $0.91 Median $1.78 Typical High $2.88 | Facility | 56 · Pre-op care only | $0.91 | $1.78 | $2.88 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $4.57 Median $8.91 Typical High $14.13 | Professional | 52 · Reduced service | $4.57 | $8.91 | $14.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.86 Median $3.55 Typical High $5.62 | Professional | 53 · Discontinued | $1.86 | $3.55 | $5.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.38 Median $2.63 Typical High $4.17 | Professional | 55 · Aftercare only | $1.38 | $2.63 | $4.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.91 Median $1.78 Typical High $2.82 | Professional | 56 · Pre-op care only | $0.91 | $1.78 | $2.82 |
Where Kentucky sits
The same service costs 3.1 times more in Wisconsin than in Louisiana. 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· 49th of 51
$16.22
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.