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 $38.90 Median $85.11 Typical High $104.71 | Facility | None | $38.90 | $85.11 | $104.71 |
Aetna Setting Facility Modifier 52 · Reduced service Typical Low $19.50 Median $42.66 Typical High $52.48 | Facility | 52 · Reduced service | $19.50 | $42.66 | $52.48 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $7.76 Median $16.98 Typical High $20.89 | Facility | 53 · Discontinued | $7.76 | $16.98 | $20.89 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $5.89 Median $12.59 Typical High $15.85 | Facility | 55 · Aftercare only | $5.89 | $12.59 | $15.85 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $3.89 Median $8.51 Typical High $10.47 | Facility | 56 · Pre-op care only | $3.89 | $8.51 | $10.47 |
Aetna Setting Professional Modifier None Typical Low $37.15 Median $81.28 Typical High $104.71 | Professional | None | $37.15 | $81.28 | $104.71 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $18.62 Median $39.81 Typical High $52.48 | Professional | 52 · Reduced service | $18.62 | $39.81 | $52.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.41 Median $16.22 Typical High $20.89 | Professional | 53 · Discontinued | $7.41 | $16.22 | $20.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.50 Median $12.02 Typical High $15.85 | Professional | 55 · Aftercare only | $5.50 | $12.02 | $15.85 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.72 Median $8.13 Typical High $10.47 | Professional | 56 · Pre-op care only | $3.72 | $8.13 | $10.47 |
Anthem BCBS Setting Professional Modifier None Typical Low $45.71 Median $64.57 Typical High $91.20 | Professional | None | $45.71 | $64.57 | $91.20 |
CareSource Setting Facility Modifier None Typical Low $33.88 Median $40.74 Typical High $63.10 | Facility | None | $33.88 | $40.74 | $63.10 |
CareSource Setting Professional Modifier None Typical Low $45.71 Median $54.95 Typical High $87.10 | Professional | None | $45.71 | $54.95 | $87.10 |
Cigna Setting Facility Modifier None Typical Low $61.66 Median $61.66 Typical High $61.66 | Facility | None | $61.66 | $61.66 | $61.66 |
Cigna Setting Professional Modifier None Typical Low $38.02 Median $77.62 Typical High $457.09 | Professional | None | $38.02 | $77.62 | $457.09 |
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 $47.86 Typical High $85.11 | Professional | None | $33.11 | $47.86 | $85.11 |
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 2.5 times more in Alaska than in Washington, DC. 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· 45th of 51
$58.88
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.