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 $66.07 Median $74.13 Typical High $91.20 | Facility | None | $66.07 | $74.13 | $91.20 |
Aetna Setting Professional Modifier None Typical Low $66.07 Median $74.13 Typical High $77.62 | Professional | None | $66.07 | $74.13 | $77.62 |
Anthem BCBS Setting Professional Modifier None Typical Low $10.72 Median $47.86 Typical High $67.61 | Professional | None | $10.72 | $47.86 | $67.61 |
CareSource Setting Facility Modifier None Typical Low $53.70 Median $64.57 Typical High $102.33 | Facility | None | $53.70 | $64.57 | $102.33 |
CareSource Setting Professional Modifier None Typical Low $57.54 Median $75.86 Typical High $102.33 | Professional | None | $57.54 | $75.86 | $102.33 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $100.00 Typical High $100.00 | Facility | None | $100.00 | $100.00 | $100.00 |
Cigna Setting Professional Modifier None Typical Low $58.88 Median $74.13 Typical High $380.19 | Professional | None | $58.88 | $74.13 | $380.19 |
Molina Setting Professional Modifier None Typical Low $44.67 Median $51.29 Typical High $67.61 | Professional | None | $44.67 | $51.29 | $67.61 |
United Setting Professional Modifier None Typical Low $69.18 Median $81.28 Typical High $117.49 | Professional | None | $69.18 | $81.28 | $117.49 |
8 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 Facility Modifier 52 · Reduced service Typical Low $33.11 Median $37.15 Typical High $45.71 | Facility | 52 · Reduced service | $33.11 | $37.15 | $45.71 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $13.18 Median $15.14 Typical High $18.20 | Facility | 53 · Discontinued | $13.18 | $15.14 | $18.20 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $9.77 Median $11.22 Typical High $13.80 | Facility | 55 · Aftercare only | $9.77 | $11.22 | $13.80 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $6.61 Median $7.41 Typical High $9.12 | Facility | 56 · Pre-op care only | $6.61 | $7.41 | $9.12 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $33.11 Median $37.15 Typical High $38.90 | Professional | 52 · Reduced service | $33.11 | $37.15 | $38.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.18 Median $15.14 Typical High $15.49 | Professional | 53 · Discontinued | $13.18 | $15.14 | $15.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.77 Median $11.22 Typical High $11.48 | Professional | 55 · Aftercare only | $9.77 | $11.22 | $11.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.61 Median $7.41 Typical High $7.76 | Professional | 56 · Pre-op care only | $6.61 | $7.41 | $7.76 |
Where Kentucky sits
The same service costs 8.1 times more in Alaska than in Indiana. 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· 50th of 51
$51.29
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.