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 $181.97 Median $223.87 Typical High $5,248.07 | Facility | None | $181.97 | $223.87 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $173.78 Median $194.98 Typical High $741.31 | Professional | None | $173.78 | $194.98 | $741.31 |
Anthem BCBS Setting Facility Modifier None Typical Low $812.83 Median $7,244.36 Typical High $11,220.18 | Facility | None | $812.83 | $7,244.36 | $11,220.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $346.74 Median $630.96 Typical High $630.96 | Professional | None | $346.74 | $630.96 | $630.96 |
CareSource Setting Facility Modifier None Typical Low $162.18 Median $263.03 Typical High $2,818.38 | Facility | None | $162.18 | $263.03 | $2,818.38 |
CareSource Setting Professional Modifier None Typical Low $165.96 Median $229.09 Typical High $275.42 | Professional | None | $165.96 | $229.09 | $275.42 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $831.76 Typical High $2,041.74 | Facility | None | $34.67 | $831.76 | $2,041.74 |
Cigna Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $831.76 | Professional | None | $363.08 | $363.08 | $831.76 |
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 $630.96 Median $831.76 Typical High $1,148.15 | Professional | None | $630.96 | $831.76 | $1,148.15 |
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 $87.10 Median $97.72 Typical High $275.42 | Professional | 52 · Reduced service | $87.10 | $97.72 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $38.90 Typical High $109.65 | Professional | 53 · Discontinued | $35.48 | $38.90 | $109.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $131.83 Median $147.91 Typical High $416.87 | Professional | 54 · Surgery only | $131.83 | $147.91 | $416.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $29.51 Typical High $83.18 | Professional | 55 · Aftercare only | $26.30 | $29.51 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $19.50 Typical High $54.95 | Professional | 56 · Pre-op care only | $17.38 | $19.50 | $54.95 |
Where Kentucky sits
The same service costs 53.7 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· 38th of 51
$708
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.