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 $173.78 Median $177.83 Typical High $2,630.27 | Facility | None | $173.78 | $177.83 | $2,630.27 |
Aetna Setting Professional Modifier None Typical Low $173.78 Median $177.83 Typical High $190.55 | Professional | None | $173.78 | $177.83 | $190.55 |
Anthem BCBS Setting Facility Modifier None Typical Low $758.58 Median $8,912.51 Typical High $11,220.18 | Facility | None | $758.58 | $8,912.51 | $11,220.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $147.91 Median $173.78 Typical High $302.00 | Professional | None | $147.91 | $173.78 | $302.00 |
CareSource Setting Facility Modifier None Typical Low $169.82 Median $275.42 Typical High $4,265.80 | Facility | None | $169.82 | $275.42 | $4,265.80 |
CareSource Setting Professional Modifier None Typical Low $173.78 Median $239.88 Typical High $281.84 | Professional | None | $173.78 | $239.88 | $281.84 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $1,071.52 Typical High $2,884.03 | Facility | None | $34.67 | $1,071.52 | $2,884.03 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $263.03 Typical High $851.14 | Professional | None | $177.83 | $263.03 | $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 $831.76 Median $2,089.30 Typical High $6,760.83 | Facility | None | $831.76 | $2,089.30 | $6,760.83 |
United Setting Professional Modifier None Typical Low $190.55 Median $229.09 Typical High $346.74 | Professional | None | $190.55 | $229.09 | $346.74 |
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 $87.10 Median $89.13 Typical High $95.50 | Professional | 52 · Reduced service | $87.10 | $89.13 | $95.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $35.48 Typical High $38.02 | Professional | 53 · Discontinued | $34.67 | $35.48 | $38.02 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $131.83 Typical High $141.25 | Professional | 54 · Surgery only | $128.82 | $131.83 | $141.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $26.92 Typical High $28.18 | Professional | 55 · Aftercare only | $25.70 | $26.92 | $28.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $17.78 Typical High $19.05 | Professional | 56 · Pre-op care only | $17.38 | $17.78 | $19.05 |
Where Kentucky sits
The same service costs 10.2 times more in Oklahoma 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
$191
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.