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 $363.08 Median $467.74 Typical High $524.81 | Facility | None | $363.08 | $467.74 | $524.81 |
Aetna Setting Professional Modifier None Typical Low $346.74 Median $446.68 Typical High $645.65 | Professional | None | $346.74 | $446.68 | $645.65 |
Ambetter Setting Professional Modifier None Typical Low $575.44 Median $602.56 Typical High $812.83 | Professional | None | $575.44 | $602.56 | $812.83 |
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 $323.59 Median $457.09 Typical High $630.96 | Professional | None | $323.59 | $457.09 | $630.96 |
CareSource Setting Facility Modifier None Typical Low $549.54 Median $562.34 Typical High $645.65 | Facility | None | $549.54 | $562.34 | $645.65 |
CareSource Setting Professional Modifier None Typical Low $512.86 Median $562.34 Typical High $741.31 | Professional | None | $512.86 | $562.34 | $741.31 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $691.83 Typical High $691.83 | Facility | None | $34.67 | $691.83 | $691.83 |
Cigna Setting Professional Modifier None Typical Low $398.11 Median $524.81 Typical High $2,754.23 | Professional | None | $398.11 | $524.81 | $2,754.23 |
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 $354.81 Median $912.01 Typical High $8,317.64 | Facility | None | $354.81 | $912.01 | $8,317.64 |
United Setting Professional Modifier None Typical Low $323.59 Median $416.87 Typical High $758.58 | Professional | None | $323.59 | $416.87 | $758.58 |
6 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 $181.97 Median $234.42 Typical High $263.03 | Facility | 52 · Reduced service | $181.97 | $234.42 | $263.03 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $54.95 Median $70.79 Typical High $79.43 | Facility | 55 · Aftercare only | $54.95 | $70.79 | $79.43 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $36.31 Median $46.77 Typical High $52.48 | Facility | 56 · Pre-op care only | $36.31 | $46.77 | $52.48 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $173.78 Median $208.93 Typical High $263.03 | Professional | 52 · Reduced service | $173.78 | $208.93 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $63.10 Typical High $79.43 | Professional | 55 · Aftercare only | $52.48 | $63.10 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $42.66 Typical High $52.48 | Professional | 56 · Pre-op care only | $34.67 | $42.66 | $52.48 |
Where Kentucky sits
The same service costs 3.1 times more in Alaska than in Indiana. 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· 49th of 51
$457
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.