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 $151.36 Median $165.96 Typical High $3,801.89 | Facility | None | $151.36 | $165.96 | $3,801.89 |
Aetna Setting Professional Modifier None Typical Low $134.90 Median $151.36 Typical High $186.21 | Professional | None | $134.90 | $151.36 | $186.21 |
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 $147.91 Median $190.55 Typical High $257.04 | Professional | None | $147.91 | $190.55 | $257.04 |
CareSource Setting Facility Modifier None Typical Low $154.88 Median $213.80 Typical High $275.42 | Facility | None | $154.88 | $213.80 | $275.42 |
CareSource Setting Professional Modifier None Typical Low $165.96 Median $229.09 Typical High $269.15 | Professional | None | $165.96 | $229.09 | $269.15 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $190.55 Typical High $281.84 | Facility | None | $34.67 | $190.55 | $281.84 |
Cigna Setting Professional Modifier None Typical Low $169.82 Median $251.19 Typical High $1,047.13 | Professional | None | $169.82 | $251.19 | $1,047.13 |
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 $162.18 Median $204.17 Typical High $331.13 | Professional | None | $162.18 | $204.17 | $331.13 |
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 $67.61 Median $74.13 Typical High $87.10 | Professional | 52 · Reduced service | $67.61 | $74.13 | $87.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.92 Median $30.20 Typical High $34.67 | Professional | 53 · Discontinued | $26.92 | $30.20 | $34.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $100.00 Median $112.20 Typical High $131.83 | Professional | 54 · Surgery only | $100.00 | $112.20 | $131.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.42 Median $22.39 Typical High $26.30 | Professional | 55 · Aftercare only | $20.42 | $22.39 | $26.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.49 Median $15.14 Typical High $17.38 | Professional | 56 · Pre-op care only | $13.49 | $15.14 | $17.38 |
Where Kentucky sits
The same service costs 3.2 times more in Alaska than in Texas. 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· 47th of 51
$191
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.