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 $40.74 Median $74.13 Typical High $91.20 | Facility | None | $40.74 | $74.13 | $91.20 |
Aetna Setting Professional Modifier None Typical Low $39.81 Median $70.79 Typical High $91.20 | Professional | None | $39.81 | $70.79 | $91.20 |
Anthem BCBS Setting Facility Modifier None Typical Low $575.44 Median $3,801.89 Typical High $11,220.18 | Facility | None | $575.44 | $3,801.89 | $11,220.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $33.88 Median $56.23 Typical High $162.18 | Professional | None | $33.88 | $56.23 | $162.18 |
CareSource Setting Facility Modifier None Typical Low $36.31 Median $524.81 Typical High $933.25 | Facility | None | $36.31 | $524.81 | $933.25 |
CareSource Setting Professional Modifier None Typical Low $33.88 Median $51.29 Typical High $61.66 | Professional | None | $33.88 | $51.29 | $61.66 |
Cigna Setting Facility Modifier None Typical Low $64.57 Median $64.57 Typical High $1,318.26 | Facility | None | $64.57 | $64.57 | $1,318.26 |
Cigna Setting Professional Modifier None Typical Low $38.02 Median $72.44 Typical High $446.68 | Professional | None | $38.02 | $72.44 | $446.68 |
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 $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 $40.74 Median $67.61 Typical High $112.20 | Professional | None | $40.74 | $67.61 | $112.20 |
10 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 $20.42 Median $37.15 Typical High $45.71 | Facility | 52 · Reduced service | $20.42 | $37.15 | $45.71 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $8.13 Median $14.79 Typical High $18.20 | Facility | 53 · Discontinued | $8.13 | $14.79 | $18.20 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $30.90 Median $54.95 Typical High $67.61 | Facility | 54 · Surgery only | $30.90 | $54.95 | $67.61 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $6.17 Median $10.96 Typical High $13.49 | Facility | 55 · Aftercare only | $6.17 | $10.96 | $13.49 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $4.07 Median $7.41 Typical High $9.12 | Facility | 56 · Pre-op care only | $4.07 | $7.41 | $9.12 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $19.95 Median $35.48 Typical High $45.71 | Professional | 52 · Reduced service | $19.95 | $35.48 | $45.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.94 Median $14.13 Typical High $18.20 | Professional | 53 · Discontinued | $7.94 | $14.13 | $18.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $30.20 Median $52.48 Typical High $67.61 | Professional | 54 · Surgery only | $30.20 | $52.48 | $67.61 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.03 Median $10.47 Typical High $13.49 | Professional | 55 · Aftercare only | $6.03 | $10.47 | $13.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.98 Median $7.08 Typical High $9.12 | Professional | 56 · Pre-op care only | $3.98 | $7.08 | $9.12 |
Where Kentucky sits
The same service costs 3.4 times more in Wisconsin than in Kentucky. 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· 51st of 51
$61.66
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.