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 $112.20 Median $125.89 Typical High $3,630.78 | Facility | None | $112.20 | $125.89 | $3,630.78 |
Aetna Setting Professional Modifier None Typical Low $102.33 Median $120.23 Typical High $199.53 | Professional | None | $102.33 | $120.23 | $199.53 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,202.26 Median $3,467.37 Typical High $11,748.98 | Facility | None | $1,202.26 | $3,467.37 | $11,748.98 |
Anthem BCBS Setting Professional Modifier None Typical Low $109.65 Median $138.04 Typical High $234.42 | Professional | None | $109.65 | $138.04 | $234.42 |
CareSource Setting Facility Modifier None Typical Low $114.82 Median $194.98 Typical High $2,818.38 | Facility | None | $114.82 | $194.98 | $2,818.38 |
CareSource Setting Professional Modifier None Typical Low $112.20 Median $173.78 Typical High $204.17 | Professional | None | $112.20 | $173.78 | $204.17 |
Cigna Setting Facility Modifier None Typical Low $213.80 Median $1,995.26 Typical High $2,290.87 | Facility | None | $213.80 | $1,995.26 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $186.21 Typical High $1,071.52 | Professional | None | $125.89 | $186.21 | $1,071.52 |
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 $741.31 Median $1,479.11 Typical High $5,128.61 | Facility | None | $741.31 | $1,479.11 | $5,128.61 |
United Setting Professional Modifier None Typical Low $120.23 Median $147.91 Typical High $234.42 | Professional | None | $120.23 | $147.91 | $234.42 |
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 $50.12 Median $56.23 Typical High $66.07 | Professional | 52 · Reduced service | $50.12 | $56.23 | $66.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.95 Median $22.39 Typical High $26.30 | Professional | 53 · Discontinued | $19.95 | $22.39 | $26.30 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $75.86 Median $83.18 Typical High $97.72 | Professional | 54 · Surgery only | $75.86 | $83.18 | $97.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $16.98 Typical High $19.50 | Professional | 55 · Aftercare only | $15.14 | $16.98 | $19.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $11.22 Typical High $13.18 | Professional | 56 · Pre-op care only | $10.00 | $11.22 | $13.18 |
Where Kentucky sits
The same service costs 10.7 times more in Oklahoma 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· 49th of 51
$148
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.