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 $91.20 Median $104.71 Typical High $3,801.89 | Facility | None | $91.20 | $104.71 | $3,801.89 |
Aetna Setting Professional Modifier None Typical Low $91.20 Median $97.72 Typical High $158.49 | Professional | None | $91.20 | $97.72 | $158.49 |
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 $75.86 Median $104.71 Typical High $173.78 | Professional | None | $75.86 | $104.71 | $173.78 |
CareSource Setting Facility Modifier None Typical Low $93.33 Median $162.18 Typical High $630.96 | Facility | None | $93.33 | $162.18 | $630.96 |
CareSource Setting Professional Modifier None Typical Low $100.00 Median $141.25 Typical High $165.96 | Professional | None | $100.00 | $141.25 | $165.96 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $398.11 Typical High $467.74 | Facility | None | $34.67 | $398.11 | $467.74 |
Cigna Setting Professional Modifier None Typical Low $102.33 Median $151.36 Typical High $831.76 | Professional | None | $102.33 | $151.36 | $831.76 |
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 $104.71 Median $144.54 Typical High $199.53 | Professional | None | $104.71 | $144.54 | $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 $44.67 Median $48.98 Typical High $58.88 | Professional | 52 · Reduced service | $44.67 | $48.98 | $58.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $19.50 Typical High $23.99 | Professional | 53 · Discontinued | $18.20 | $19.50 | $23.99 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $67.61 Median $72.44 Typical High $89.13 | Professional | 54 · Surgery only | $67.61 | $72.44 | $89.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $14.79 Typical High $17.78 | Professional | 55 · Aftercare only | $13.49 | $14.79 | $17.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $9.77 Typical High $12.02 | Professional | 56 · Pre-op care only | $9.12 | $9.77 | $12.02 |
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· 48th of 51
$115
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.