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 $104.71 Median $123.03 Typical High $794.33 | Facility | None | $104.71 | $123.03 | $794.33 |
Aetna Setting Professional Modifier None Typical Low $104.71 Median $114.82 Typical High $138.04 | Professional | None | $104.71 | $114.82 | $138.04 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,621.81 Median $2,691.53 Typical High $9,120.11 | Facility | None | $1,621.81 | $2,691.53 | $9,120.11 |
Anthem BCBS Setting Professional Modifier None Typical Low $104.71 Median $125.89 Typical High $1,584.89 | Professional | None | $104.71 | $125.89 | $1,584.89 |
CareSource Setting Facility Modifier None Typical Low $100.00 Median $120.23 Typical High $186.21 | Facility | None | $100.00 | $120.23 | $186.21 |
CareSource Setting Professional Modifier None Typical Low $107.15 Median $162.18 Typical High $190.55 | Professional | None | $107.15 | $162.18 | $190.55 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $204.17 Typical High $794.33 | Facility | None | $34.67 | $204.17 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $177.83 Typical High $758.58 | Professional | None | $120.23 | $177.83 | $758.58 |
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 $125.89 Median $162.18 Typical High $229.09 | Professional | None | $125.89 | $162.18 | $229.09 |
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 $52.48 Median $57.54 Typical High $69.18 | Professional | 52 · Reduced service | $52.48 | $57.54 | $69.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $22.91 Typical High $27.54 | Professional | 53 · Discontinued | $20.89 | $22.91 | $27.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $79.43 Median $85.11 Typical High $102.33 | Professional | 54 · Surgery only | $79.43 | $85.11 | $102.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $16.98 Typical High $20.89 | Professional | 55 · Aftercare only | $15.85 | $16.98 | $20.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $11.48 Typical High $13.80 | Professional | 56 · Pre-op care only | $10.47 | $11.48 | $13.80 |
Where Kentucky sits
The same service costs 3.9 times more in Alaska than in Utah. 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· 47th of 51
$141
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.