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 $7.41 Median $7.59 Typical High $794.33 | Facility | None | $7.41 | $7.59 | $794.33 |
Aetna Setting Professional Modifier None Typical Low $7.41 Median $7.59 Typical High $7.76 | Professional | None | $7.41 | $7.59 | $7.76 |
Anthem BCBS Setting Professional Modifier None Typical Low $6.61 Median $11.75 Typical High $20.42 | Professional | None | $6.61 | $11.75 | $20.42 |
CareSource Setting Facility Modifier None Typical Low $1.26 Median $6.03 Typical High $9.55 | Facility | None | $1.26 | $6.03 | $9.55 |
CareSource Setting Professional Modifier None Typical Low $1.12 Median $1.58 Typical High $2.82 | Professional | None | $1.12 | $1.58 | $2.82 |
Cigna Setting Facility Modifier None Typical Low $11.48 Median $11.48 Typical High $11.48 | Facility | None | $11.48 | $11.48 | $11.48 |
Cigna Setting Professional Modifier None Typical Low $7.41 Median $13.49 Typical High $134.90 | Professional | None | $7.41 | $13.49 | $134.90 |
United Setting Professional Modifier None Typical Low $8.13 Median $10.00 Typical High $15.85 | Professional | None | $8.13 | $10.00 | $15.85 |
5 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 $3.72 Median $3.80 Typical High $3.89 | Professional | 52 · Reduced service | $3.72 | $3.80 | $3.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.48 Median $1.51 Typical High $1.55 | Professional | 53 · Discontinued | $1.48 | $1.51 | $1.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $5.62 Median $5.75 Typical High $5.89 | Professional | 54 · Surgery only | $5.62 | $5.75 | $5.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.12 Median $1.12 Typical High $1.17 | Professional | 55 · Aftercare only | $1.12 | $1.12 | $1.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.76 Median $0.76 Typical High $0.78 | Professional | 56 · Pre-op care only | $0.76 | $0.76 | $0.78 |
Where Kentucky sits
The same service costs 2.3 times more in Hawaii than in North Carolina. 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· 33rd of 51
$10.23
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.