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 $117.49 Median $158.49 Typical High $3,801.89 | Facility | None | $117.49 | $158.49 | $3,801.89 |
Aetna Setting Professional Modifier None Typical Low $117.49 Median $134.90 Typical High $186.21 | Professional | None | $117.49 | $134.90 | $186.21 |
Anthem BCBS Setting Facility Modifier None Typical Low $602.56 Median $1,698.24 Typical High $2,884.03 | Facility | None | $602.56 | $1,698.24 | $2,884.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $95.50 Median $128.82 Typical High $186.21 | Professional | None | $95.50 | $128.82 | $186.21 |
CareSource Setting Facility Modifier None Typical Low $107.15 Median $173.78 Typical High $2,691.53 | Facility | None | $107.15 | $173.78 | $2,691.53 |
CareSource Setting Professional Modifier None Typical Low $107.15 Median $151.36 Typical High $177.83 | Professional | None | $107.15 | $151.36 | $177.83 |
Cigna Setting Facility Modifier None Typical Low $177.83 Median $1,318.26 Typical High $2,454.71 | Facility | None | $177.83 | $1,318.26 | $2,454.71 |
Cigna Setting Professional Modifier None Typical Low $112.20 Median $229.09 Typical High $691.83 | Professional | None | $112.20 | $229.09 | $691.83 |
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 $741.31 Median $1,479.11 Typical High $5,128.61 | Facility | None | $741.31 | $1,479.11 | $5,128.61 |
United Setting Professional Modifier None Typical Low $134.90 Median $181.97 Typical High $234.42 | Professional | None | $134.90 | $181.97 | $234.42 |
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 $58.88 Median $64.57 Typical High $87.10 | Professional | 52 · Reduced service | $58.88 | $64.57 | $87.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $25.70 Typical High $35.48 | Professional | 53 · Discontinued | $23.44 | $25.70 | $35.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $89.13 Median $97.72 Typical High $131.83 | Professional | 54 · Surgery only | $89.13 | $97.72 | $131.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $19.50 Typical High $26.30 | Professional | 55 · Aftercare only | $17.78 | $19.50 | $26.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $12.88 Typical High $17.78 | Professional | 56 · Pre-op care only | $11.75 | $12.88 | $17.78 |
Where Kentucky sits
The same service costs 12.9 times more in Arkansas 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· 46th of 51
$158
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.