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 $223.87 Median $281.84 Typical High $288.40 | Facility | None | $223.87 | $281.84 | $288.40 |
Aetna Setting Professional Modifier None Typical Low $275.42 Median $281.84 Typical High $316.23 | Professional | None | $275.42 | $281.84 | $316.23 |
Ambetter Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $295.12 | Professional | None | $295.12 | $295.12 | $295.12 |
Anthem BCBS Setting Professional Modifier None Typical Low $181.97 Median $213.80 Typical High $331.13 | Professional | None | $181.97 | $213.80 | $331.13 |
CareSource Setting Facility Modifier None Typical Low $229.09 Median $275.42 Typical High $436.52 | Facility | None | $229.09 | $275.42 | $436.52 |
CareSource Setting Professional Modifier None Typical Low $269.15 Median $288.40 Typical High $380.19 | Professional | None | $269.15 | $288.40 | $380.19 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $524.81 Typical High $524.81 | Facility | None | $524.81 | $524.81 | $524.81 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $275.42 Typical High $1,479.11 | Professional | None | $229.09 | $275.42 | $1,479.11 |
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 $204.17 Median $239.88 Typical High $363.08 | Professional | None | $204.17 | $239.88 | $363.08 |
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 $138.04 Median $141.25 Typical High $144.54 | Professional | 52 · Reduced service | $138.04 | $141.25 | $144.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $56.23 Typical High $57.54 | Professional | 53 · Discontinued | $54.95 | $56.23 | $57.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $42.66 Typical High $43.65 | Professional | 55 · Aftercare only | $41.69 | $42.66 | $43.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $28.18 Typical High $28.84 | Professional | 56 · Pre-op care only | $27.54 | $28.18 | $28.84 |
Where Kentucky sits
The same service costs 2.8 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· 47th of 51
$251
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.