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 $10.00 Median $12.30 Typical High $25.12 | Facility | None | $10.00 | $12.30 | $25.12 |
Aetna Setting Professional Modifier None Typical Low $9.55 Median $10.00 Typical High $12.30 | Professional | None | $9.55 | $10.00 | $12.30 |
Anthem BCBS Setting Professional Modifier None Typical Low $12.30 Median $12.30 Typical High $28.18 | Professional | None | $12.30 | $12.30 | $28.18 |
CareSource Setting Facility Modifier None Typical Low $8.71 Median $10.47 Typical High $16.22 | Facility | None | $8.71 | $10.47 | $16.22 |
CareSource Setting Professional Modifier None Typical Low $10.23 Median $14.45 Typical High $20.42 | Professional | None | $10.23 | $14.45 | $20.42 |
Cigna Setting Facility Modifier None Typical Low $19.95 Median $19.95 Typical High $19.95 | Facility | None | $19.95 | $19.95 | $19.95 |
Cigna Setting Professional Modifier None Typical Low $9.12 Median $11.22 Typical High $295.12 | Professional | None | $9.12 | $11.22 | $295.12 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | None | $30.20 | $30.20 | $30.20 |
United Setting Professional Modifier None Typical Low $9.12 Median $11.22 Typical High $18.62 | Professional | None | $9.12 | $11.22 | $18.62 |
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 $4.79 Median $5.01 Typical High $6.17 | Professional | 52 · Reduced service | $4.79 | $5.01 | $6.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.95 Median $2.04 Typical High $2.45 | Professional | 53 · Discontinued | $1.95 | $2.04 | $2.45 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.45 Median $1.51 Typical High $1.86 | Professional | 55 · Aftercare only | $1.45 | $1.51 | $1.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.95 Median $1.00 Typical High $1.23 | Professional | 56 · Pre-op care only | $0.95 | $1.00 | $1.23 |
Where Kentucky sits
The same service costs 3.2 times more in Alaska than in Florida. 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· 29th of 51
$12.30
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.