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 $54.95 Median $107.15 Typical High $131.83 | Facility | None | $54.95 | $107.15 | $131.83 |
Aetna Setting Facility Modifier 52 · Reduced service Typical Low $27.54 Median $53.70 Typical High $66.07 | Facility | 52 · Reduced service | $27.54 | $53.70 | $66.07 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $10.96 Median $21.38 Typical High $26.30 | Facility | 53 · Discontinued | $10.96 | $21.38 | $26.30 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $8.32 Median $15.85 Typical High $19.95 | Facility | 55 · Aftercare only | $8.32 | $15.85 | $19.95 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $5.50 Median $10.72 Typical High $13.18 | Facility | 56 · Pre-op care only | $5.50 | $10.72 | $13.18 |
Aetna Setting Professional Modifier None Typical Low $51.29 Median $102.33 Typical High $131.83 | Professional | None | $51.29 | $102.33 | $131.83 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $25.70 Median $51.29 Typical High $66.07 | Professional | 52 · Reduced service | $25.70 | $51.29 | $66.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.23 Median $20.42 Typical High $26.30 | Professional | 53 · Discontinued | $10.23 | $20.42 | $26.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.76 Median $15.14 Typical High $19.95 | Professional | 55 · Aftercare only | $7.76 | $15.14 | $19.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.13 Median $10.23 Typical High $13.18 | Professional | 56 · Pre-op care only | $5.13 | $10.23 | $13.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $64.57 Median $79.43 Typical High $93.33 | Professional | None | $64.57 | $79.43 | $93.33 |
CareSource Setting Facility Modifier None Typical Low $47.86 Median $57.54 Typical High $91.20 | Facility | None | $47.86 | $57.54 | $91.20 |
CareSource Setting Professional Modifier None Typical Low $61.66 Median $79.43 Typical High $112.20 | Professional | None | $61.66 | $79.43 | $112.20 |
Cigna Setting Facility Modifier None Typical Low $85.11 Median $85.11 Typical High $85.11 | Facility | None | $85.11 | $85.11 | $85.11 |
Cigna Setting Professional Modifier None Typical Low $52.48 Median $97.72 Typical High $549.54 | Professional | None | $52.48 | $97.72 | $549.54 |
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 $66.07 Typical High $100.00 | Professional | None | $33.11 | $66.07 | $100.00 |
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
$79.43
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.