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 $147.91 Median $173.78 Typical High $5,248.07 | Facility | None | $147.91 | $173.78 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $147.91 Median $158.49 Typical High $223.87 | Professional | None | $147.91 | $158.49 | $223.87 |
Anthem BCBS Setting Facility Modifier None Typical Low $724.44 Median $1,995.26 Typical High $4,265.80 | Facility | None | $724.44 | $1,995.26 | $4,265.80 |
Anthem BCBS Setting Professional Modifier None Typical Low $134.90 Median $177.83 Typical High $281.84 | Professional | None | $134.90 | $177.83 | $281.84 |
CareSource Setting Facility Modifier None Typical Low $158.49 Median $707.95 Typical High $1,258.93 | Facility | None | $158.49 | $707.95 | $1,258.93 |
CareSource Setting Professional Modifier None Typical Low $165.96 Median $223.87 Typical High $275.42 | Professional | None | $165.96 | $223.87 | $275.42 |
Cigna Setting Facility Modifier None Typical Low $275.42 Median $288.40 Typical High $1,659.59 | Facility | None | $275.42 | $288.40 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $169.82 Median $218.78 Typical High $1,174.90 | Professional | None | $169.82 | $218.78 | $1,174.90 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $134.90 | Professional | None | $33.11 | $33.11 | $134.90 |
United Setting Facility Modifier None Typical Low $70.79 Median $186.21 Typical High $1,148.15 | Facility | None | $70.79 | $186.21 | $1,148.15 |
United Setting Professional Modifier None Typical Low $173.78 Median $245.47 Typical High $316.23 | Professional | None | $173.78 | $245.47 | $316.23 |
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 $74.13 Median $79.43 Typical High $102.33 | Professional | 52 · Reduced service | $74.13 | $79.43 | $102.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $29.51 Median $32.36 Typical High $41.69 | Professional | 53 · Discontinued | $29.51 | $32.36 | $41.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $112.20 Median $120.23 Typical High $154.88 | Professional | 54 · Surgery only | $112.20 | $120.23 | $154.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $23.99 Typical High $30.90 | Professional | 55 · Aftercare only | $22.39 | $23.99 | $30.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.79 Median $15.85 Typical High $20.89 | Professional | 56 · Pre-op care only | $14.79 | $15.85 | $20.89 |
Where Kentucky sits
The same service costs 4.5 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· 42nd of 51
$191
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.