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 $125.89 Median $169.82 Typical High $3,801.89 | Facility | None | $125.89 | $169.82 | $3,801.89 |
Aetna Setting Professional Modifier None Typical Low $125.89 Median $141.25 Typical High $181.97 | Professional | None | $125.89 | $141.25 | $181.97 |
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 $107.15 Median $128.82 Typical High $204.17 | Professional | None | $107.15 | $128.82 | $204.17 |
CareSource Setting Facility Modifier None Typical Low $97.72 Median $186.21 Typical High $398.11 | Facility | None | $97.72 | $186.21 | $398.11 |
CareSource Setting Professional Modifier None Typical Low $114.82 Median $144.54 Typical High $190.55 | Professional | None | $114.82 | $144.54 | $190.55 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $263.03 Typical High $398.11 | Facility | None | $34.67 | $263.03 | $398.11 |
Cigna Setting Professional Modifier None Typical Low $117.49 Median $154.88 Typical High $1,202.26 | Professional | None | $117.49 | $154.88 | $1,202.26 |
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 $120.23 Median $169.82 Typical High $245.47 | Professional | None | $120.23 | $169.82 | $245.47 |
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 $63.10 Median $69.18 Typical High $89.13 | Professional | 52 · Reduced service | $63.10 | $69.18 | $89.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $28.18 Typical High $36.31 | Professional | 53 · Discontinued | $25.70 | $28.18 | $36.31 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $95.50 Median $104.71 Typical High $134.90 | Professional | 54 · Surgery only | $95.50 | $104.71 | $134.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $20.89 Typical High $26.92 | Professional | 55 · Aftercare only | $19.05 | $20.89 | $26.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $13.80 Typical High $18.20 | Professional | 56 · Pre-op care only | $12.59 | $13.80 | $18.20 |
Where Kentucky sits
The same service costs 5.1 times more in Alaska than in Utah. 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
$129
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.