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 $39.81 Median $53.70 Typical High $3,801.89 | Facility | None | $39.81 | $53.70 | $3,801.89 |
Aetna Setting Professional Modifier None Typical Low $39.81 Median $53.70 Typical High $177.83 | Professional | None | $39.81 | $53.70 | $177.83 |
Anthem BCBS Setting Facility Modifier None Typical Low $575.44 Median $3,801.89 Typical High $11,220.18 | Facility | None | $575.44 | $3,801.89 | $11,220.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $33.11 Median $43.65 Typical High $173.78 | Professional | None | $33.11 | $43.65 | $173.78 |
CareSource Setting Facility Modifier None Typical Low $35.48 Median $524.81 Typical High $933.25 | Facility | None | $35.48 | $524.81 | $933.25 |
CareSource Setting Professional Modifier None Typical Low $39.81 Median $51.29 Typical High $60.26 | Professional | None | $39.81 | $51.29 | $60.26 |
Cigna Setting Facility Modifier None Typical Low $53.70 Median $58.88 Typical High $1,071.52 | Facility | None | $53.70 | $58.88 | $1,071.52 |
Cigna Setting Professional Modifier None Typical Low $37.15 Median $75.86 Typical High $954.99 | Professional | None | $37.15 | $75.86 | $954.99 |
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 $70.79 Median $186.21 Typical High $1,148.15 | Facility | None | $70.79 | $186.21 | $1,148.15 |
United Setting Professional Modifier None Typical Low $43.65 Median $63.10 Typical High $79.43 | Professional | None | $43.65 | $63.10 | $79.43 |
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 $19.95 Median $21.88 Typical High $54.95 | Professional | 52 · Reduced service | $19.95 | $21.88 | $54.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.94 Median $8.91 Typical High $22.39 | Professional | 53 · Discontinued | $7.94 | $8.91 | $22.39 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $30.20 Median $33.11 Typical High $83.18 | Professional | 54 · Surgery only | $30.20 | $33.11 | $83.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.03 Median $6.61 Typical High $16.60 | Professional | 55 · Aftercare only | $6.03 | $6.61 | $16.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.98 Median $4.47 Typical High $11.22 | Professional | 56 · Pre-op care only | $3.98 | $4.47 | $11.22 |
Where Kentucky sits
The same service costs 9.3 times more in Tennessee 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· 45th of 51
$51.29
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.