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 $10.96 Median $13.18 Typical High $33.11 | Facility | None | $10.96 | $13.18 | $33.11 |
Aetna Setting Professional Modifier None Typical Low $10.96 Median $13.18 Typical High $19.95 | Professional | None | $10.96 | $13.18 | $19.95 |
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 $10.72 Median $16.98 Typical High $36.31 | Professional | None | $10.72 | $16.98 | $36.31 |
CareSource Setting Facility Modifier None Typical Low $7.24 Median $9.33 Typical High $13.80 | Facility | None | $7.24 | $9.33 | $13.80 |
Cigna Setting Facility Modifier None Typical Low $6.61 Median $18.62 Typical High $398.11 | Facility | None | $6.61 | $18.62 | $398.11 |
Cigna Setting Professional Modifier None Typical Low $11.48 Median $19.95 Typical High $177.83 | Professional | None | $11.48 | $19.95 | $177.83 |
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 $12.30 Median $20.42 Typical High $28.84 | Professional | None | $12.30 | $20.42 | $28.84 |
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 $5.37 Median $6.46 Typical High $16.60 | Facility | 52 · Reduced service | $5.37 | $6.46 | $16.60 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $2.19 Median $2.63 Typical High $6.61 | Facility | 53 · Discontinued | $2.19 | $2.63 | $6.61 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $8.13 Median $9.77 Typical High $24.55 | Facility | 54 · Surgery only | $8.13 | $9.77 | $24.55 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $1.62 Median $1.95 Typical High $4.90 | Facility | 55 · Aftercare only | $1.62 | $1.95 | $4.90 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $1.07 Median $1.29 Typical High $3.31 | Facility | 56 · Pre-op care only | $1.07 | $1.29 | $3.31 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $5.37 Median $6.46 Typical High $7.41 | Professional | 52 · Reduced service | $5.37 | $6.46 | $7.41 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.19 Median $2.51 Typical High $2.95 | Professional | 53 · Discontinued | $2.19 | $2.51 | $2.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $8.13 Median $9.55 Typical High $10.96 | Professional | 54 · Surgery only | $8.13 | $9.55 | $10.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.62 Median $1.91 Typical High $2.19 | Professional | 55 · Aftercare only | $1.62 | $1.91 | $2.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.07 Median $1.29 Typical High $1.48 | Professional | 56 · Pre-op care only | $1.07 | $1.29 | $1.48 |
Where Kentucky sits
The same service costs 3.5 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· 42nd of 51
$16.98
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.