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 $45.71 Median $89.13 Typical High $109.65 | Facility | None | $45.71 | $89.13 | $109.65 |
Aetna Setting Facility Modifier 52 · Reduced service Typical Low $22.91 Median $44.67 Typical High $54.95 | Facility | 52 · Reduced service | $22.91 | $44.67 | $54.95 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $9.12 Median $17.78 Typical High $21.88 | Facility | 53 · Discontinued | $9.12 | $17.78 | $21.88 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $6.92 Median $13.49 Typical High $16.60 | Facility | 55 · Aftercare only | $6.92 | $13.49 | $16.60 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $4.57 Median $8.91 Typical High $10.96 | Facility | 56 · Pre-op care only | $4.57 | $8.91 | $10.96 |
Aetna Setting Professional Modifier None Typical Low $43.65 Median $85.11 Typical High $109.65 | Professional | None | $43.65 | $85.11 | $109.65 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $21.88 Median $42.66 Typical High $54.95 | Professional | 52 · Reduced service | $21.88 | $42.66 | $54.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.71 Median $16.98 Typical High $21.88 | Professional | 53 · Discontinued | $8.71 | $16.98 | $21.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.61 Median $12.59 Typical High $16.60 | Professional | 55 · Aftercare only | $6.61 | $12.59 | $16.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $8.51 Typical High $10.96 | Professional | 56 · Pre-op care only | $4.37 | $8.51 | $10.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $54.95 Median $70.79 Typical High $93.33 | Professional | None | $54.95 | $70.79 | $93.33 |
CareSource Setting Facility Modifier None Typical Low $39.81 Median $47.86 Typical High $74.13 | Facility | None | $39.81 | $47.86 | $74.13 |
CareSource Setting Professional Modifier None Typical Low $53.70 Median $66.07 Typical High $93.33 | Professional | None | $53.70 | $66.07 | $93.33 |
Cigna Setting Facility Modifier None Typical Low $72.44 Median $72.44 Typical High $72.44 | Facility | None | $72.44 | $72.44 | $72.44 |
Cigna Setting Professional Modifier None Typical Low $45.71 Median $81.28 Typical High $478.63 | Professional | None | $45.71 | $81.28 | $478.63 |
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 $33.11 Median $54.95 Typical High $89.13 | Professional | None | $33.11 | $54.95 | $89.13 |
1 more rate 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 |
|---|---|---|---|---|---|
United Setting Professional Modifier XC Typical Low $501.19 Median $501.19 Typical High $501.19 | Professional | XC | $501.19 | $501.19 | $501.19 |
Where Kentucky sits
The same service costs 2.8 times more in Alaska than in Maryland. 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
$67.61
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.