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 $138.04 Median $288.40 Typical High $794.33 | Facility | None | $138.04 | $288.40 | $794.33 |
Aetna Setting Professional Modifier None Typical Low $138.04 Median $288.40 Typical High $489.78 | Professional | None | $138.04 | $288.40 | $489.78 |
Ambetter Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $389.05 | Professional | None | $389.05 | $389.05 | $389.05 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,238.72 Median $5,495.41 Typical High $14,454.40 | Facility | None | $2,238.72 | $5,495.41 | $14,454.40 |
Anthem BCBS Setting Professional Modifier None Typical Low $144.54 Median $251.19 Typical High $537.03 | Professional | None | $144.54 | $251.19 | $537.03 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $218.78 Median $371.54 Typical High $812.83 | Professional | 50 · Both sides | $218.78 | $371.54 | $812.83 |
CareSource Setting Facility Modifier None Typical Low $117.49 Median $794.33 Typical High $1,445.44 | Facility | None | $117.49 | $794.33 | $1,445.44 |
CareSource Setting Professional Modifier None Typical Low $112.20 Median $173.78 Typical High $204.17 | Professional | None | $112.20 | $173.78 | $204.17 |
Cigna Setting Facility Modifier None Typical Low $213.80 Median $1,071.52 Typical High $3,311.31 | Facility | None | $213.80 | $1,071.52 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $144.54 Median $416.87 Typical High $2,511.89 | Professional | None | $144.54 | $416.87 | $2,511.89 |
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 $204.17 Median $331.13 Typical High $691.83 | Professional | None | $204.17 | $331.13 | $691.83 |
6 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 54 · Surgery only Typical Low $102.33 Median $165.96 Typical High $389.05 | Facility | 54 · Surgery only | $102.33 | $165.96 | $389.05 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $20.42 Median $33.11 Typical High $77.62 | Facility | 55 · Aftercare only | $20.42 | $33.11 | $77.62 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $13.80 Median $22.39 Typical High $51.29 | Facility | 56 · Pre-op care only | $13.80 | $22.39 | $51.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $102.33 Median $218.78 Typical High $346.74 | Professional | 54 · Surgery only | $102.33 | $218.78 | $346.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.42 Median $43.65 Typical High $69.18 | Professional | 55 · Aftercare only | $20.42 | $43.65 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $28.84 Typical High $45.71 | Professional | 56 · Pre-op care only | $13.80 | $28.84 | $45.71 |
Where Kentucky sits
The same service costs 3.4 times more in Alaska 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· 46th of 51
$288
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.