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 $109.65 Typical High $3,801.89 | Facility | None | $95.50 | $109.65 | $3,801.89 |
Aetna Setting Professional Modifier None Typical Low $95.50 Median $102.33 Typical High $144.54 | Professional | None | $95.50 | $102.33 | $144.54 |
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 $91.20 Median $109.65 Typical High $169.82 | Professional | None | $91.20 | $109.65 | $169.82 |
CareSource Setting Facility Modifier None Typical Low $97.72 Median $169.82 Typical High $630.96 | Facility | None | $97.72 | $169.82 | $630.96 |
CareSource Setting Professional Modifier None Typical Low $104.71 Median $147.91 Typical High $173.78 | Professional | None | $104.71 | $147.91 | $173.78 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $363.08 Typical High $467.74 | Facility | None | $34.67 | $363.08 | $467.74 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $162.18 Typical High $794.33 | Professional | None | $107.15 | $162.18 | $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 $323.59 Median $588.84 Typical High $1,621.81 | Facility | None | $323.59 | $588.84 | $1,621.81 |
United Setting Professional Modifier None Typical Low $109.65 Median $138.04 Typical High $199.53 | Professional | None | $109.65 | $138.04 | $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 $47.86 Median $51.29 Typical High $63.10 | Professional | 52 · Reduced service | $47.86 | $51.29 | $63.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.05 Median $20.42 Typical High $25.12 | Professional | 53 · Discontinued | $19.05 | $20.42 | $25.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $70.79 Median $77.62 Typical High $93.33 | Professional | 54 · Surgery only | $70.79 | $77.62 | $93.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.13 Median $15.49 Typical High $18.62 | Professional | 55 · Aftercare only | $14.13 | $15.49 | $18.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.55 Median $10.23 Typical High $12.59 | Professional | 56 · Pre-op care only | $9.55 | $10.23 | $12.59 |
Where Kentucky sits
The same service costs 4.4 times more in Alaska 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· 50th of 51
$117
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.