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 $363.08 Median $436.52 Typical High $3,801.89 | Facility | None | $363.08 | $436.52 | $3,801.89 |
Aetna Setting Professional Modifier None Typical Low $346.74 Median $363.08 Typical High $478.63 | Professional | None | $346.74 | $363.08 | $478.63 |
Anthem BCBS Setting Facility Modifier None Typical Low $602.56 Median $1,698.24 Typical High $2,884.03 | Facility | None | $602.56 | $1,698.24 | $2,884.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $302.00 Median $398.11 Typical High $501.19 | Professional | None | $302.00 | $398.11 | $501.19 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $457.09 Median $588.84 Typical High $758.58 | Professional | 50 · Both sides | $457.09 | $588.84 | $758.58 |
CareSource Setting Facility Modifier None Typical Low $323.59 Median $524.81 Typical High $2,818.38 | Facility | None | $323.59 | $524.81 | $2,818.38 |
CareSource Setting Professional Modifier None Typical Low $363.08 Median $457.09 Typical High $549.54 | Professional | None | $363.08 | $457.09 | $549.54 |
Cigna Setting Facility Modifier None Typical Low $562.34 Median $1,318.26 Typical High $2,041.74 | Facility | None | $562.34 | $1,318.26 | $2,041.74 |
Cigna Setting Professional Modifier None Typical Low $338.84 Median $512.86 Typical High $2,238.72 | Professional | None | $338.84 | $512.86 | $2,238.72 |
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 $338.84 Median $478.63 Typical High $645.65 | Professional | None | $338.84 | $478.63 | $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 $173.78 Median $181.97 Typical High $234.42 | Professional | 52 · Reduced service | $173.78 | $181.97 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $72.44 Typical High $93.33 | Professional | 53 · Discontinued | $69.18 | $72.44 | $93.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $275.42 Typical High $346.74 | Professional | 54 · Surgery only | $263.03 | $275.42 | $346.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $54.95 Typical High $70.79 | Professional | 55 · Aftercare only | $52.48 | $54.95 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $36.31 Typical High $46.77 | Professional | 56 · Pre-op care only | $34.67 | $36.31 | $46.77 |
Where Kentucky sits
The same service costs 3.9 times more in Alaska than in New York. 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· 41st 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.