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 $58.88 Median $102.33 Typical High $794.33 | Facility | None | $58.88 | $102.33 | $794.33 |
Aetna Setting Professional Modifier None Typical Low $58.88 Median $91.20 Typical High $134.90 | Professional | None | $58.88 | $91.20 | $134.90 |
Anthem BCBS Setting Facility Modifier None Typical Low $588.84 Median $1,698.24 Typical High $2,884.03 | Facility | None | $588.84 | $1,698.24 | $2,884.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $53.70 Median $69.18 Typical High $123.03 | Professional | None | $53.70 | $69.18 | $123.03 |
CareSource Setting Facility Modifier None Typical Low $58.88 Median $72.44 Typical High $97.72 | Facility | None | $58.88 | $72.44 | $97.72 |
CareSource Setting Professional Modifier None Typical Low $60.26 Median $85.11 Typical High $100.00 | Professional | None | $60.26 | $85.11 | $100.00 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $69.18 Typical High $398.11 | Facility | None | $34.67 | $69.18 | $398.11 |
Cigna Setting Professional Modifier None Typical Low $61.66 Median $100.00 Typical High $660.69 | Professional | None | $61.66 | $100.00 | $660.69 |
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 $323.59 Median $588.84 Typical High $1,621.81 | Facility | None | $323.59 | $588.84 | $1,621.81 |
United Setting Professional Modifier None Typical Low $66.07 Median $100.00 Typical High $151.36 | Professional | None | $66.07 | $100.00 | $151.36 |
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 $29.51 Median $44.67 Typical High $63.10 | Facility | 52 · Reduced service | $29.51 | $44.67 | $63.10 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $11.75 Median $18.20 Typical High $25.12 | Facility | 53 · Discontinued | $11.75 | $18.20 | $25.12 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $44.67 Median $67.61 Typical High $93.33 | Facility | 54 · Surgery only | $44.67 | $67.61 | $93.33 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $8.91 Median $13.49 Typical High $19.05 | Facility | 55 · Aftercare only | $8.91 | $13.49 | $19.05 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $5.89 Median $9.12 Typical High $12.59 | Facility | 56 · Pre-op care only | $5.89 | $9.12 | $12.59 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $29.51 Median $43.65 Typical High $50.12 | Professional | 52 · Reduced service | $29.51 | $43.65 | $50.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.75 Median $17.78 Typical High $20.42 | Professional | 53 · Discontinued | $11.75 | $17.78 | $20.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $44.67 Median $66.07 Typical High $75.86 | Professional | 54 · Surgery only | $44.67 | $66.07 | $75.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.91 Median $13.18 Typical High $15.14 | Professional | 55 · Aftercare only | $8.91 | $13.18 | $15.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.89 Median $8.91 Typical High $10.23 | Professional | 56 · Pre-op care only | $5.89 | $8.91 | $10.23 |
Where Kentucky sits
The same service costs 3.6 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
$77.62
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.