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 $44.67 Median $194.98 Typical High $363.08 | Facility | None | $44.67 | $194.98 | $363.08 |
Aetna Setting Professional Modifier None Typical Low $44.67 Median $162.18 Typical High $269.15 | Professional | None | $44.67 | $162.18 | $269.15 |
Ambetter Setting Professional Modifier None Typical Low $34.67 Median $34.67 Typical High $181.97 | Professional | None | $34.67 | $34.67 | $181.97 |
Anthem BCBS Setting Facility Modifier None Typical Low $9,120.11 Median $10,715.19 Typical High $11,220.18 | Facility | None | $9,120.11 | $10,715.19 | $11,220.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $39.81 Median $162.18 Typical High $616.60 | Professional | None | $39.81 | $162.18 | $616.60 |
CareSource Setting Facility Modifier None Typical Low $33.88 Median $40.74 Typical High $64.57 | Facility | None | $33.88 | $40.74 | $64.57 |
CareSource Setting Professional Modifier None Typical Low $39.81 Median $56.23 Typical High $66.07 | Professional | None | $39.81 | $56.23 | $66.07 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $67.61 Typical High $67.61 | Facility | None | $34.67 | $67.61 | $67.61 |
Cigna Setting Professional Modifier None Typical Low $40.74 Median $186.21 Typical High $1,445.44 | Professional | None | $40.74 | $186.21 | $1,445.44 |
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 $50.12 Median $416.87 Typical High $1,949.84 | Facility | None | $50.12 | $416.87 | $1,949.84 |
United Setting Professional Modifier None Typical Low $45.71 Median $177.83 Typical High $295.12 | Professional | None | $45.71 | $177.83 | $295.12 |
8 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 $22.39 Median $97.72 Typical High $131.83 | Facility | 52 · Reduced service | $22.39 | $97.72 | $131.83 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $8.91 Median $38.90 Typical High $53.70 | Facility | 53 · Discontinued | $8.91 | $38.90 | $53.70 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $6.61 Median $29.51 Typical High $39.81 | Facility | 55 · Aftercare only | $6.61 | $29.51 | $39.81 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $4.47 Median $19.50 Typical High $26.92 | Facility | 56 · Pre-op care only | $4.47 | $19.50 | $26.92 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $21.38 Median $81.28 Typical High $128.82 | Professional | 52 · Reduced service | $21.38 | $81.28 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.71 Median $32.36 Typical High $51.29 | Professional | 53 · Discontinued | $8.71 | $32.36 | $51.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.46 Median $24.55 Typical High $38.90 | Professional | 55 · Aftercare only | $6.46 | $24.55 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.27 Median $16.22 Typical High $25.70 | Professional | 56 · Pre-op care only | $4.27 | $16.22 | $25.70 |
Where Kentucky sits
The same service costs 5.2 times more in North Carolina than in Hawaii. 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· 34th of 51
$162
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.