How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $120.23 Median $123.03 Typical High $3,801.89 | Facility | None | $120.23 | $123.03 | $3,801.89 |
Aetna Setting Professional Modifier None Typical Low $114.82 Median $123.03 Typical High $141.25 | Professional | None | $114.82 | $123.03 | $141.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $9,120.11 Median $10,715.19 Typical High $11,220.18 | Facility | None | $9,120.11 | $10,715.19 | $11,220.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $114.82 Median $147.91 Typical High $208.93 | Professional | None | $114.82 | $147.91 | $208.93 |
CareSource Setting Facility Modifier None Typical Low $102.33 Median $123.03 Typical High $190.55 | Facility | None | $102.33 | $123.03 | $190.55 |
CareSource Setting Professional Modifier None Typical Low $120.23 Median $165.96 Typical High $199.53 | Professional | None | $120.23 | $165.96 | $199.53 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $194.98 Typical High $194.98 | Facility | None | $34.67 | $194.98 | $194.98 |
Cigna Setting Professional Modifier None Typical Low $123.03 Median $204.17 Typical High $851.14 | Professional | None | $123.03 | $204.17 | $851.14 |
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 $50.12 Median $416.87 Typical High $1,949.84 | Facility | None | $50.12 | $416.87 | $1,949.84 |
United Setting Professional Modifier None Typical Low $125.89 Median $173.78 Typical High $239.88 | Professional | None | $125.89 | $173.78 | $239.88 |
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 $57.54 Median $61.66 Typical High $69.18 | Professional | 52 · Reduced service | $57.54 | $61.66 | $69.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $24.55 Typical High $27.54 | Professional | 53 · Discontinued | $22.91 | $24.55 | $27.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $87.10 Median $93.33 Typical High $104.71 | Professional | 54 · Surgery only | $87.10 | $93.33 | $104.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $18.62 Typical High $20.89 | Professional | 55 · Aftercare only | $17.38 | $18.62 | $20.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $12.30 Typical High $13.80 | Professional | 56 · Pre-op care only | $11.48 | $12.30 | $13.80 |
Where Kentucky sits
The same service costs 3.7 times more in Alaska 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· 41st of 51
$148
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.