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 $102.33 Median $120.23 Typical High $794.33 | Facility | None | $102.33 | $120.23 | $794.33 |
Aetna Setting Professional Modifier None Typical Low $102.33 Median $104.71 Typical High $131.83 | Professional | None | $102.33 | $104.71 | $131.83 |
Anthem BCBS Setting Facility Modifier None Typical Low $128.82 Median $181.97 Typical High $9,120.11 | Facility | None | $128.82 | $181.97 | $9,120.11 |
Anthem BCBS Setting Professional Modifier None Typical Low $89.13 Median $107.15 Typical High $151.36 | Professional | None | $89.13 | $107.15 | $151.36 |
CareSource Setting Facility Modifier None Typical Low $83.18 Median $100.00 Typical High $158.49 | Facility | None | $83.18 | $100.00 | $158.49 |
CareSource Setting Professional Modifier None Typical Low $89.13 Median $123.03 Typical High $158.49 | Professional | None | $89.13 | $123.03 | $158.49 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $169.82 Typical High $794.33 | Facility | None | $34.67 | $169.82 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $100.00 Median $123.03 Typical High $630.96 | Professional | None | $100.00 | $123.03 | $630.96 |
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 $354.81 Median $912.01 Typical High $8,317.64 | Facility | None | $354.81 | $912.01 | $8,317.64 |
United Setting Professional Modifier None Typical Low $97.72 Median $134.90 Typical High $173.78 | Professional | None | $97.72 | $134.90 | $173.78 |
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 $51.29 Median $52.48 Typical High $66.07 | Professional | 52 · Reduced service | $51.29 | $52.48 | $66.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $20.89 Typical High $26.30 | Professional | 53 · Discontinued | $20.89 | $20.89 | $26.30 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $77.62 Median $79.43 Typical High $97.72 | Professional | 54 · Surgery only | $77.62 | $79.43 | $97.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $15.85 Typical High $19.50 | Professional | 55 · Aftercare only | $15.49 | $15.85 | $19.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $10.47 Typical High $13.18 | Professional | 56 · Pre-op care only | $10.23 | $10.47 | $13.18 |
Where Kentucky sits
The same service costs 4.4 times more in Alaska than in New Jersey. 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· 47th of 51
$107
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.