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 $95.50 Median $107.15 Typical High $794.33 | Facility | None | $95.50 | $107.15 | $794.33 |
Aetna Setting Professional Modifier None Typical Low $85.11 Median $95.50 Typical High $112.20 | Professional | None | $85.11 | $95.50 | $112.20 |
Anthem BCBS Setting Facility Modifier None Typical Low $758.58 Median $9,549.93 Typical High $11,220.18 | Facility | None | $758.58 | $9,549.93 | $11,220.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $85.11 Median $109.65 Typical High $186.21 | Professional | None | $85.11 | $109.65 | $186.21 |
CareSource Setting Facility Modifier None Typical Low $89.13 Median $107.15 Typical High $165.96 | Facility | None | $89.13 | $107.15 | $165.96 |
CareSource Setting Professional Modifier None Typical Low $102.33 Median $144.54 Typical High $169.82 | Professional | None | $102.33 | $144.54 | $169.82 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $177.83 Typical High $199.53 | Facility | None | $34.67 | $177.83 | $199.53 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $144.54 Typical High $794.33 | Professional | None | $107.15 | $144.54 | $794.33 |
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 $100.00 Median $112.20 Typical High $199.53 | Professional | None | $100.00 | $112.20 | $199.53 |
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 $42.66 Median $46.77 Typical High $54.95 | Professional | 52 · Reduced service | $42.66 | $46.77 | $54.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $19.05 Typical High $21.88 | Professional | 53 · Discontinued | $16.98 | $19.05 | $21.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $64.57 Median $70.79 Typical High $83.18 | Professional | 54 · Surgery only | $64.57 | $70.79 | $83.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $14.13 Typical High $16.60 | Professional | 55 · Aftercare only | $12.88 | $14.13 | $16.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $9.55 Typical High $10.96 | Professional | 56 · Pre-op care only | $8.51 | $9.55 | $10.96 |
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· 50th of 51
$112
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.