How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $117.49 Median $120.23 Typical High $151.36 | Facility | None | $117.49 | $120.23 | $151.36 |
Aetna Setting Professional Modifier None Typical Low $117.49 Median $120.23 Typical High $151.36 | Professional | None | $117.49 | $120.23 | $151.36 |
Ambetter Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $104.71 | Professional | None | $104.71 | $104.71 | $104.71 |
Anthem BCBS Setting Professional Modifier None Typical Low $100.00 Median $120.23 Typical High $158.49 | Professional | None | $100.00 | $120.23 | $158.49 |
CareSource Setting Facility Modifier None Typical Low $95.50 Median $114.82 Typical High $181.97 | Facility | None | $95.50 | $114.82 | $181.97 |
CareSource Setting Professional Modifier None Typical Low $100.00 Median $141.25 Typical High $181.97 | Professional | None | $100.00 | $141.25 | $181.97 |
Cigna Setting Facility Modifier None Typical Low $181.97 Median $181.97 Typical High $181.97 | Facility | None | $181.97 | $181.97 | $181.97 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $125.89 Typical High $741.31 | Professional | None | $107.15 | $125.89 | $741.31 |
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 Professional Modifier None Typical Low $97.72 Median $120.23 Typical High $181.97 | Professional | None | $97.72 | $120.23 | $181.97 |
4 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 $58.88 Median $58.88 Typical High $61.66 | Professional | 52 · Reduced service | $58.88 | $58.88 | $61.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $23.44 Typical High $24.55 | Professional | 53 · Discontinued | $23.44 | $23.44 | $24.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $17.78 Typical High $18.20 | Professional | 55 · Aftercare only | $17.38 | $17.78 | $18.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $11.75 Typical High $12.30 | Professional | 56 · Pre-op care only | $11.75 | $11.75 | $12.30 |
Where Kentucky sits
The same service costs 3.2 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· 43rd of 51
$120
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.