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 $457.09 Median $575.44 Typical High $2,630.27 | Facility | None | $457.09 | $575.44 | $2,630.27 |
Aetna Setting Professional Modifier None Typical Low $436.52 Median $467.74 Typical High $575.44 | Professional | None | $436.52 | $467.74 | $575.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,000.00 Median $8,912.51 Typical High $11,220.18 | Facility | None | $1,000.00 | $8,912.51 | $11,220.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $302.00 Median $363.08 Typical High $436.52 | Professional | None | $302.00 | $363.08 | $436.52 |
CareSource Setting Facility Modifier None Typical Low $416.87 Median $676.08 Typical High $12,022.64 | Facility | None | $416.87 | $676.08 | $12,022.64 |
CareSource Setting Professional Modifier None Typical Low $467.74 Median $602.56 Typical High $707.95 | Professional | None | $467.74 | $602.56 | $707.95 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $794.33 Typical High $9,332.54 | Facility | None | $34.67 | $794.33 | $9,332.54 |
Cigna Setting Professional Modifier None Typical Low $416.87 Median $478.63 Typical High $2,089.30 | Professional | None | $416.87 | $478.63 | $2,089.30 |
Molina Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $44.67 | Professional | None | $44.67 | $44.67 | $44.67 |
United Setting Facility Modifier None Typical Low $707.95 Median $1,174.90 Typical High $3,890.45 | Facility | None | $707.95 | $1,174.90 | $3,890.45 |
United Setting Professional Modifier None Typical Low $371.54 Median $501.19 Typical High $741.31 | Professional | None | $371.54 | $501.19 | $741.31 |
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 $218.78 Median $234.42 Typical High $288.40 | Professional | 52 · Reduced service | $218.78 | $234.42 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $87.10 Median $95.50 Typical High $114.82 | Professional | 53 · Discontinued | $87.10 | $95.50 | $114.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $354.81 Typical High $436.52 | Professional | 54 · Surgery only | $331.13 | $354.81 | $436.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $70.79 Typical High $87.10 | Professional | 55 · Aftercare only | $66.07 | $70.79 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $46.77 Typical High $57.54 | Professional | 56 · Pre-op care only | $43.65 | $46.77 | $57.54 |
Where Kentucky sits
The same service costs 5.9 times more in Arkansas 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· 50th of 51
$380
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.