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 $109.65 Median $144.54 Typical High $5,248.07 | Facility | None | $109.65 | $144.54 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $109.65 Median $114.82 Typical High $158.49 | Professional | None | $109.65 | $114.82 | $158.49 |
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 $81.28 Median $100.00 Typical High $151.36 | Professional | None | $81.28 | $100.00 | $151.36 |
CareSource Setting Facility Modifier None Typical Low $97.72 Median $158.49 Typical High $398.11 | Facility | None | $97.72 | $158.49 | $398.11 |
CareSource Setting Professional Modifier None Typical Low $91.20 Median $123.03 Typical High $158.49 | Professional | None | $91.20 | $123.03 | $158.49 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $263.03 Typical High $691.83 | Facility | None | $34.67 | $263.03 | $691.83 |
Cigna Setting Professional Modifier None Typical Low $100.00 Median $114.82 Typical High $588.84 | Professional | None | $100.00 | $114.82 | $588.84 |
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 $93.33 Median $125.89 Typical High $199.53 | Professional | None | $93.33 | $125.89 | $199.53 |
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 $54.95 Median $57.54 Typical High $79.43 | Professional | 52 · Reduced service | $54.95 | $57.54 | $79.43 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $22.91 Typical High $31.62 | Professional | 53 · Discontinued | $21.88 | $22.91 | $31.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $81.28 Median $87.10 Typical High $120.23 | Professional | 54 · Surgery only | $81.28 | $87.10 | $120.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $17.38 Typical High $23.99 | Professional | 55 · Aftercare only | $16.22 | $17.38 | $23.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $11.48 Typical High $15.85 | Professional | 56 · Pre-op care only | $10.96 | $11.48 | $15.85 |
Where Kentucky sits
The same service costs 4.8 times more in Alaska than in Florida. 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· 44th of 51
$110
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.