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 $15.14 Median $26.92 Typical High $42.66 | Facility | None | $15.14 | $26.92 | $42.66 |
Aetna Setting Professional Modifier None Typical Low $15.14 Median $26.92 Typical High $36.31 | Professional | None | $15.14 | $26.92 | $36.31 |
Anthem BCBS Setting Facility Modifier None Typical Low $20.89 Median $3,388.44 Typical High $11,220.18 | Facility | None | $20.89 | $3,388.44 | $11,220.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $12.88 Median $21.88 Typical High $30.20 | Professional | None | $12.88 | $21.88 | $30.20 |
CareSource Setting Facility Modifier None Typical Low $13.80 Median $21.88 Typical High $851.14 | Facility | None | $13.80 | $21.88 | $851.14 |
CareSource Setting Professional Modifier None Typical Low $16.60 Median $24.55 Typical High $34.67 | Professional | None | $16.60 | $24.55 | $34.67 |
Cigna Setting Facility Modifier None Typical Low $23.44 Median $23.44 Typical High $53.70 | Facility | None | $23.44 | $23.44 | $53.70 |
Cigna Setting Professional Modifier None Typical Low $15.85 Median $36.31 Typical High $177.83 | Professional | None | $15.85 | $36.31 | $177.83 |
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 $19.05 Median $30.90 Typical High $54.95 | Professional | None | $19.05 | $30.90 | $54.95 |
10 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 $7.59 Median $13.49 Typical High $18.20 | Facility | 52 · Reduced service | $7.59 | $13.49 | $18.20 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $3.02 Median $5.37 Typical High $7.24 | Facility | 53 · Discontinued | $3.02 | $5.37 | $7.24 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $11.48 Median $20.42 Typical High $26.92 | Facility | 54 · Surgery only | $11.48 | $20.42 | $26.92 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $2.29 Median $4.07 Typical High $5.37 | Facility | 55 · Aftercare only | $2.29 | $4.07 | $5.37 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $1.51 Median $2.69 Typical High $3.63 | Facility | 56 · Pre-op care only | $1.51 | $2.69 | $3.63 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $7.59 Median $13.49 Typical High $18.20 | Professional | 52 · Reduced service | $7.59 | $13.49 | $18.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.02 Median $5.37 Typical High $7.24 | Professional | 53 · Discontinued | $3.02 | $5.37 | $7.24 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $11.48 Median $20.42 Typical High $26.92 | Professional | 54 · Surgery only | $11.48 | $20.42 | $26.92 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.29 Median $4.07 Typical High $5.37 | Professional | 55 · Aftercare only | $2.29 | $4.07 | $5.37 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.51 Median $2.69 Typical High $3.63 | Professional | 56 · Pre-op care only | $1.51 | $2.69 | $3.63 |
Where Kentucky sits
The same service costs 3.5 times more in Wisconsin than in Kentucky. 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· 51st of 51
$25.12
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.