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 $426.58 Median $478.63 Typical High $489.78 | Facility | None | $426.58 | $478.63 | $489.78 |
Aetna Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $489.78 | Professional | None | $478.63 | $478.63 | $489.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $346.74 Median $407.38 Typical High $588.84 | Professional | None | $346.74 | $407.38 | $588.84 |
CareSource Setting Facility Modifier None Typical Low $389.05 Median $467.74 Typical High $741.31 | Facility | None | $389.05 | $467.74 | $741.31 |
CareSource Setting Professional Modifier None Typical Low $416.87 Median $575.44 Typical High $741.31 | Professional | None | $416.87 | $575.44 | $741.31 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $870.96 Typical High $870.96 | Facility | None | $524.81 | $870.96 | $870.96 |
Cigna Setting Professional Modifier None Typical Low $416.87 Median $478.63 Typical High $2,511.89 | Professional | None | $416.87 | $478.63 | $2,511.89 |
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 $389.05 Median $457.09 Typical High $691.83 | Professional | None | $389.05 | $457.09 | $691.83 |
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 $239.88 Median $239.88 Typical High $245.47 | Professional | 52 · Reduced service | $239.88 | $239.88 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $95.50 Typical High $100.00 | Professional | 53 · Discontinued | $95.50 | $95.50 | $100.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $72.44 Typical High $74.13 | Professional | 55 · Aftercare only | $70.79 | $72.44 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $47.86 Typical High $48.98 | Professional | 56 · Pre-op care only | $47.86 | $47.86 | $48.98 |
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
$427
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.