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 $389.05 Median $489.78 Typical High $8,511.38 | Facility | None | $389.05 | $489.78 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $389.05 Median $398.11 Typical High $489.78 | Professional | None | $389.05 | $398.11 | $489.78 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,995.26 Median $5,495.41 Typical High $14,454.40 | Facility | None | $1,995.26 | $5,495.41 | $14,454.40 |
Anthem BCBS Setting Professional Modifier None Typical Low $346.74 Median $426.58 Typical High $537.03 | Professional | None | $346.74 | $426.58 | $537.03 |
CareSource Setting Facility Modifier None Typical Low $363.08 Median $602.56 Typical High $4,570.88 | Facility | None | $363.08 | $602.56 | $4,570.88 |
CareSource Setting Professional Modifier None Typical Low $338.84 Median $446.68 Typical High $602.56 | Professional | None | $338.84 | $446.68 | $602.56 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $3,311.31 Typical High $5,495.41 | Facility | None | $630.96 | $3,311.31 | $5,495.41 |
Cigna Setting Professional Modifier None Typical Low $380.19 Median $478.63 Typical High $2,398.83 | Professional | None | $380.19 | $478.63 | $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 $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 $380.19 Median $562.34 Typical High $691.83 | Professional | None | $380.19 | $562.34 | $691.83 |
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 $194.98 Median $199.53 Typical High $245.47 | Professional | 52 · Reduced service | $194.98 | $199.53 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $77.62 Median $79.43 Typical High $100.00 | Professional | 53 · Discontinued | $77.62 | $79.43 | $100.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $295.12 Median $302.00 Typical High $371.54 | Professional | 54 · Surgery only | $295.12 | $302.00 | $371.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $60.26 Typical High $74.13 | Professional | 55 · Aftercare only | $58.88 | $60.26 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $39.81 Typical High $48.98 | Professional | 56 · Pre-op care only | $38.90 | $39.81 | $48.98 |
Where Kentucky sits
The same service costs 4.5 times more in Alaska than in Texas. 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· 40th of 51
$427
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.