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 $83.18 Median $416.87 Typical High $1,023.29 | Facility | None | $83.18 | $416.87 | $1,023.29 |
Aetna Setting Professional Modifier None Typical Low $83.18 Median $117.49 Typical High $1,023.29 | Professional | None | $83.18 | $117.49 | $1,023.29 |
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 $41.69 Median $77.62 Typical High $794.33 | Professional | None | $41.69 | $77.62 | $794.33 |
CareSource Setting Facility Modifier None Typical Low $75.86 Median $125.89 Typical High $1,071.52 | Facility | None | $75.86 | $125.89 | $1,071.52 |
CareSource Setting Professional Modifier None Typical Low $70.79 Median $97.72 Typical High $125.89 | Professional | None | $70.79 | $97.72 | $125.89 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $398.11 Typical High $794.33 | Facility | None | $34.67 | $398.11 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $81.28 Median $831.76 Typical High $4,897.79 | Professional | None | $81.28 | $831.76 | $4,897.79 |
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 $457.09 Median $794.33 Typical High $2,454.71 | Facility | None | $457.09 | $794.33 | $2,454.71 |
United Setting Professional Modifier None Typical Low $79.43 Median $234.42 Typical High $1,122.02 | Professional | None | $79.43 | $234.42 | $1,122.02 |
9 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 Facility Modifier 52 · Reduced service Typical Low $40.74 Median $52.48 Typical High $512.86 | Facility | 52 · Reduced service | $40.74 | $52.48 | $512.86 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $16.60 Median $20.89 Typical High $204.17 | Facility | 53 · Discontinued | $16.60 | $20.89 | $204.17 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $61.66 Median $77.62 Typical High $758.58 | Facility | 54 · Surgery only | $61.66 | $77.62 | $758.58 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $12.30 Median $15.49 Typical High $154.88 | Facility | 55 · Aftercare only | $12.30 | $15.49 | $154.88 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $40.74 Median $58.88 Typical High $512.86 | Professional | 52 · Reduced service | $40.74 | $58.88 | $512.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $23.44 Typical High $204.17 | Professional | 53 · Discontinued | $16.60 | $23.44 | $204.17 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $61.66 Median $87.10 Typical High $758.58 | Professional | 54 · Surgery only | $61.66 | $87.10 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $17.38 Typical High $154.88 | Professional | 55 · Aftercare only | $12.30 | $17.38 | $154.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $11.75 Typical High $102.33 | Professional | 56 · Pre-op care only | $8.32 | $11.75 | $102.33 |
Where Kentucky sits
The same service costs 14.1 times more in Washington 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
$91.20
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.