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 $630.96 Median $741.31 Typical High $758.58 | Facility | None | $630.96 | $741.31 | $758.58 |
Aetna Setting Professional Modifier None Typical Low $724.44 Median $741.31 Typical High $758.58 | Professional | None | $724.44 | $741.31 | $758.58 |
Anthem BCBS Setting Professional Modifier None Typical Low $512.86 Median $602.56 Typical High $870.96 | Professional | None | $512.86 | $602.56 | $870.96 |
CareSource Setting Facility Modifier None Typical Low $602.56 Median $724.44 Typical High $1,148.15 | Facility | None | $602.56 | $724.44 | $1,148.15 |
CareSource Setting Professional Modifier None Typical Low $630.96 Median $891.25 Typical High $1,148.15 | Professional | None | $630.96 | $891.25 | $1,148.15 |
Cigna Setting Facility Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $1,348.96 | Facility | None | $1,348.96 | $1,348.96 | $1,348.96 |
Cigna Setting Professional Modifier None Typical Low $616.60 Median $724.44 Typical High $3,801.89 | Professional | None | $616.60 | $724.44 | $3,801.89 |
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 $575.44 Median $676.08 Typical High $1,023.29 | Professional | None | $575.44 | $676.08 | $1,023.29 |
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 $363.08 Median $371.54 Typical High $380.19 | Professional | 52 · Reduced service | $363.08 | $371.54 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $147.91 Typical High $151.36 | Professional | 53 · Discontinued | $147.91 | $147.91 | $151.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $112.20 Typical High $114.82 | Professional | 55 · Aftercare only | $109.65 | $112.20 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $74.13 Typical High $75.86 | Professional | 56 · Pre-op care only | $72.44 | $74.13 | $75.86 |
Where Kentucky sits
The same service costs 3.2 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
$631
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.