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 $26.92 Median $70.79 Typical High $3,801.89 | Facility | None | $26.92 | $70.79 | $3,801.89 |
Aetna Setting Professional Modifier None Typical Low $31.62 Median $57.54 Typical High $70.79 | Professional | None | $31.62 | $57.54 | $70.79 |
Anthem BCBS Setting Facility Modifier None Typical Low $758.58 Median $5,248.07 Typical High $11,220.18 | Facility | None | $758.58 | $5,248.07 | $11,220.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $21.88 Median $21.88 Typical High $95.50 | Professional | None | $21.88 | $21.88 | $95.50 |
CareSource Setting Facility Modifier None Typical Low $51.29 Median $83.18 Typical High $218.78 | Facility | None | $51.29 | $83.18 | $218.78 |
CareSource Setting Professional Modifier None Typical Low $57.54 Median $74.13 Typical High $87.10 | Professional | None | $57.54 | $74.13 | $87.10 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $147.91 Typical High $691.83 | Facility | None | $34.67 | $147.91 | $691.83 |
Cigna Setting Professional Modifier None Typical Low $36.31 Median $57.54 Typical High $263.03 | Professional | None | $36.31 | $57.54 | $263.03 |
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 $70.79 Median $186.21 Typical High $1,148.15 | Facility | None | $70.79 | $186.21 | $1,148.15 |
United Setting Professional Modifier None Typical Low $21.88 Median $29.51 Typical High $42.66 | Professional | None | $21.88 | $29.51 | $42.66 |
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 $15.85 Median $28.84 Typical High $35.48 | Professional | 52 · Reduced service | $15.85 | $28.84 | $35.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.31 Median $11.75 Typical High $14.13 | Professional | 53 · Discontinued | $6.31 | $11.75 | $14.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $23.99 Median $43.65 Typical High $53.70 | Professional | 54 · Surgery only | $23.99 | $43.65 | $53.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.79 Median $8.71 Typical High $10.72 | Professional | 55 · Aftercare only | $4.79 | $8.71 | $10.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.16 Median $5.75 Typical High $7.08 | Professional | 56 · Pre-op care only | $3.16 | $5.75 | $7.08 |
Where Kentucky sits
The same service costs 9.1 times more in Tennessee than in Maine. 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· 44th of 51
$47.86
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.