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 $676.08 Median $812.83 Typical High $954.99 | Facility | None | $676.08 | $812.83 | $954.99 |
Aetna Setting Professional Modifier None Typical Low $645.65 Median $812.83 Typical High $1,174.90 | Professional | None | $645.65 | $812.83 | $1,174.90 |
Ambetter Setting Professional Modifier None Typical Low $912.01 Median $1,096.48 Typical High $1,412.54 | Professional | None | $912.01 | $1,096.48 | $1,412.54 |
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 $575.44 Median $758.58 Typical High $1,000.00 | Professional | None | $575.44 | $758.58 | $1,000.00 |
CareSource Setting Facility Modifier None Typical Low $1,000.00 Median $1,047.13 Typical High $1,174.90 | Facility | None | $1,000.00 | $1,047.13 | $1,174.90 |
CareSource Setting Professional Modifier None Typical Low $933.25 Median $1,047.13 Typical High $1,348.96 | Professional | None | $933.25 | $1,047.13 | $1,348.96 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $794.33 Typical High $1,288.25 | Facility | None | $34.67 | $794.33 | $1,288.25 |
Cigna Setting Professional Modifier None Typical Low $707.95 Median $1,023.29 Typical High $5,128.61 | Professional | None | $707.95 | $1,023.29 | $5,128.61 |
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 $575.44 Median $741.31 Typical High $1,380.38 | Professional | None | $575.44 | $741.31 | $1,380.38 |
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 $338.84 Median $407.38 Typical High $478.63 | Facility | 52 · Reduced service | $338.84 | $407.38 | $478.63 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $100.00 Median $123.03 Typical High $144.54 | Facility | 55 · Aftercare only | $100.00 | $123.03 | $144.54 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $67.61 Median $81.28 Typical High $95.50 | Facility | 56 · Pre-op care only | $67.61 | $81.28 | $95.50 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $323.59 Median $389.05 Typical High $478.63 | Professional | 52 · Reduced service | $323.59 | $389.05 | $478.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $114.82 Typical High $144.54 | Professional | 55 · Aftercare only | $95.50 | $114.82 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $77.62 Typical High $95.50 | Professional | 56 · Pre-op care only | $64.57 | $77.62 | $95.50 |
Where Kentucky sits
The same service costs 3.2 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· 50th of 51
$776
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.