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 $338.84 Median $436.52 Typical High $5,248.07 | Facility | None | $338.84 | $436.52 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $338.84 Median $354.81 Typical High $436.52 | Professional | None | $338.84 | $354.81 | $436.52 |
Anthem BCBS Setting Facility Modifier None Typical Low $724.44 Median $1,995.26 Typical High $4,265.80 | Facility | None | $724.44 | $1,995.26 | $4,265.80 |
Anthem BCBS Setting Professional Modifier None Typical Low $302.00 Median $416.87 Typical High $524.81 | Professional | None | $302.00 | $416.87 | $524.81 |
CareSource Setting Facility Modifier None Typical Low $316.23 Median $524.81 Typical High $1,445.44 | Facility | None | $316.23 | $524.81 | $1,445.44 |
CareSource Setting Professional Modifier None Typical Low $288.40 Median $407.38 Typical High $524.81 | Professional | None | $288.40 | $407.38 | $524.81 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $1,000.00 Typical High $1,659.59 | Facility | None | $524.81 | $1,000.00 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $331.13 Median $467.74 Typical High $2,398.83 | Professional | None | $331.13 | $467.74 | $2,398.83 |
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 $707.95 Median $1,174.90 Typical High $3,890.45 | Facility | None | $707.95 | $1,174.90 | $3,890.45 |
United Setting Professional Modifier None Typical Low $331.13 Median $512.86 Typical High $645.65 | Professional | None | $331.13 | $512.86 | $645.65 |
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 $169.82 Median $173.78 Typical High $218.78 | Professional | 52 · Reduced service | $169.82 | $173.78 | $218.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $69.18 Typical High $87.10 | Professional | 53 · Discontinued | $69.18 | $69.18 | $87.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $263.03 Typical High $323.59 | Professional | 54 · Surgery only | $257.04 | $263.03 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $52.48 Typical High $64.57 | Professional | 55 · Aftercare only | $51.29 | $52.48 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $34.67 Typical High $43.65 | Professional | 56 · Pre-op care only | $33.88 | $34.67 | $43.65 |
Where Kentucky sits
The same service costs 4.8 times more in Alaska than in Utah. 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· 38th of 51
$417
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.