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 $38.90 Median $144.54 Typical High $851.14 | Facility | None | $38.90 | $144.54 | $851.14 |
Aetna Setting Professional Modifier None Typical Low $38.90 Median $57.54 Typical High $181.97 | Professional | None | $38.90 | $57.54 | $181.97 |
Anthem BCBS Setting Facility Modifier None Typical Low $575.44 Median $3,801.89 Typical High $11,220.18 | Facility | None | $575.44 | $3,801.89 | $11,220.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $32.36 Median $58.88 Typical High $128.82 | Professional | None | $32.36 | $58.88 | $128.82 |
CareSource Setting Facility Modifier None Typical Low $36.31 Median $707.95 Typical High $1,258.93 | Facility | None | $36.31 | $707.95 | $1,258.93 |
CareSource Setting Professional Modifier None Typical Low $36.31 Median $45.71 Typical High $60.26 | Professional | None | $36.31 | $45.71 | $60.26 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $66.07 Typical High $77.62 | Facility | None | $34.67 | $66.07 | $77.62 |
Cigna Setting Professional Modifier None Typical Low $38.02 Median $144.54 Typical High $812.83 | Professional | None | $38.02 | $144.54 | $812.83 |
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 $323.59 Median $588.84 Typical High $1,621.81 | Facility | None | $323.59 | $588.84 | $1,621.81 |
United Setting Professional Modifier None Typical Low $41.69 Median $91.20 Typical High $173.78 | Professional | None | $41.69 | $91.20 | $173.78 |
10 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 $19.50 Median $28.84 Typical High $91.20 | Facility | 52 · Reduced service | $19.50 | $28.84 | $91.20 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $7.76 Median $11.75 Typical High $36.31 | Facility | 53 · Discontinued | $7.76 | $11.75 | $36.31 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $28.84 Median $43.65 Typical High $134.90 | Facility | 54 · Surgery only | $28.84 | $43.65 | $134.90 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $5.75 Median $8.71 Typical High $26.92 | Facility | 55 · Aftercare only | $5.75 | $8.71 | $26.92 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $3.89 Median $5.75 Typical High $18.20 | Facility | 56 · Pre-op care only | $3.89 | $5.75 | $18.20 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $19.50 Median $28.84 Typical High $91.20 | Professional | 52 · Reduced service | $19.50 | $28.84 | $91.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.76 Median $11.75 Typical High $36.31 | Professional | 53 · Discontinued | $7.76 | $11.75 | $36.31 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $28.84 Median $43.65 Typical High $134.90 | Professional | 54 · Surgery only | $28.84 | $43.65 | $134.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.75 Median $8.71 Typical High $26.92 | Professional | 55 · Aftercare only | $5.75 | $8.71 | $26.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.89 Median $5.75 Typical High $18.20 | Professional | 56 · Pre-op care only | $3.89 | $5.75 | $18.20 |
Where Kentucky sits
The same service costs 4.6 times more in Wisconsin than in Washington, DC. 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· 48th of 51
$61.66
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.