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 $141.25 Median $186.21 Typical High $2,630.27 | Facility | None | $141.25 | $186.21 | $2,630.27 |
Aetna Setting Professional Modifier None Typical Low $141.25 Median $181.97 Typical High $218.78 | Professional | None | $141.25 | $181.97 | $218.78 |
Anthem BCBS Setting Facility Modifier None Typical Low $954.99 Median $2,884.03 Typical High $8,511.38 | Facility | None | $954.99 | $2,884.03 | $8,511.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $112.20 Median $162.18 Typical High $251.19 | Professional | None | $112.20 | $162.18 | $251.19 |
CareSource Setting Facility Modifier None Typical Low $120.23 Median $204.17 Typical High $7,413.10 | Facility | None | $120.23 | $204.17 | $7,413.10 |
CareSource Setting Professional Modifier None Typical Low $114.82 Median $177.83 Typical High $208.93 | Professional | None | $114.82 | $177.83 | $208.93 |
Cigna Setting Facility Modifier None Typical Low $218.78 Median $1,862.09 Typical High $3,801.89 | Facility | None | $218.78 | $1,862.09 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $131.83 Median $288.40 Typical High $954.99 | Professional | None | $131.83 | $288.40 | $954.99 |
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 $977.24 Median $1,862.09 Typical High $7,943.28 | Facility | None | $977.24 | $1,862.09 | $7,943.28 |
United Setting Professional Modifier None Typical Low $165.96 Median $218.78 Typical High $281.84 | Professional | None | $165.96 | $218.78 | $281.84 |
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 $69.18 Median $77.62 Typical High $100.00 | Professional | 52 · Reduced service | $69.18 | $77.62 | $100.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $30.90 Typical High $39.81 | Professional | 53 · Discontinued | $28.18 | $30.90 | $39.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $117.49 Typical High $151.36 | Professional | 54 · Surgery only | $104.71 | $117.49 | $151.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $23.44 Typical High $30.20 | Professional | 55 · Aftercare only | $20.89 | $23.44 | $30.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $15.49 Typical High $19.95 | Professional | 56 · Pre-op care only | $14.13 | $15.49 | $19.95 |
Where Kentucky sits
The same service costs 20.4 times more in Kansas 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· 45th of 51
$204
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.