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 $63.10 Median $138.04 Typical High $158.49 | Facility | None | $63.10 | $138.04 | $158.49 |
Aetna Setting Professional Modifier None Typical Low $63.10 Median $128.82 Typical High $154.88 | Professional | None | $63.10 | $128.82 | $154.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $47.86 Median $57.54 Typical High $138.04 | Professional | None | $47.86 | $57.54 | $138.04 |
CareSource Setting Facility Modifier None Typical Low $51.29 Median $61.66 Typical High $97.72 | Facility | None | $51.29 | $61.66 | $97.72 |
CareSource Setting Professional Modifier None Typical Low $60.26 Median $85.11 Typical High $120.23 | Professional | None | $60.26 | $85.11 | $120.23 |
Cigna Setting Facility Modifier None Typical Low $74.13 Median $93.33 Typical High $128.82 | Facility | None | $74.13 | $93.33 | $128.82 |
Cigna Setting Professional Modifier None Typical Low $61.66 Median $141.25 Typical High $831.76 | Professional | None | $61.66 | $141.25 | $831.76 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $53.70 | Professional | None | $33.11 | $33.11 | $53.70 |
United Setting Professional Modifier None Typical Low $64.57 Median $125.89 Typical High $199.53 | Professional | None | $64.57 | $125.89 | $199.53 |
10 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 $31.62 Median $69.18 Typical High $77.62 | Facility | 52 · Reduced service | $31.62 | $69.18 | $77.62 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $12.59 Median $27.54 Typical High $31.62 | Facility | 53 · Discontinued | $12.59 | $27.54 | $31.62 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $46.77 Median $104.71 Typical High $117.49 | Facility | 54 · Surgery only | $46.77 | $104.71 | $117.49 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $9.33 Median $20.89 Typical High $23.44 | Facility | 55 · Aftercare only | $9.33 | $20.89 | $23.44 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $6.31 Median $13.80 Typical High $15.85 | Facility | 56 · Pre-op care only | $6.31 | $13.80 | $15.85 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $31.62 Median $64.57 Typical High $72.44 | Professional | 52 · Reduced service | $31.62 | $64.57 | $72.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.59 Median $25.70 Typical High $28.84 | Professional | 53 · Discontinued | $12.59 | $25.70 | $28.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $46.77 Median $95.50 Typical High $109.65 | Professional | 54 · Surgery only | $46.77 | $95.50 | $109.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.33 Median $20.42 Typical High $21.88 | Professional | 55 · Aftercare only | $9.33 | $20.42 | $21.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.31 Median $13.49 Typical High $14.45 | Professional | 56 · Pre-op care only | $6.31 | $13.49 | $14.45 |
Where Kentucky sits
The same service costs 3.5 times more in Alaska than in Kentucky. 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· 51st of 51
$75.86
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.