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 $10.72 Median $11.22 Typical High $12.59 | Facility | None | $10.72 | $11.22 | $12.59 |
Aetna Setting Professional Modifier None Typical Low $10.72 Median $10.96 Typical High $12.59 | Professional | None | $10.72 | $10.96 | $12.59 |
Ambetter Setting Professional Modifier None Typical Low $11.22 Median $11.75 Typical High $11.75 | Professional | None | $11.22 | $11.75 | $11.75 |
Anthem BCBS Setting Professional Modifier None Typical Low $7.24 Median $8.51 Typical High $11.48 | Professional | None | $7.24 | $8.51 | $11.48 |
CareSource Setting Facility Modifier None Typical Low $8.71 Median $10.47 Typical High $16.60 | Facility | None | $8.71 | $10.47 | $16.60 |
CareSource Setting Professional Modifier None Typical Low $10.47 Median $11.22 Typical High $14.45 | Professional | None | $10.47 | $11.22 | $14.45 |
Cigna Setting Facility Modifier None Typical Low $19.50 Median $19.50 Typical High $19.50 | Facility | None | $19.50 | $19.50 | $19.50 |
Cigna Setting Professional Modifier None Typical Low $10.72 Median $14.13 Typical High $56.23 | Professional | None | $10.72 | $14.13 | $56.23 |
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 $10.72 Median $12.59 Typical High $20.89 | Professional | None | $10.72 | $12.59 | $20.89 |
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 $5.37 Median $5.50 Typical High $6.31 | Professional | 52 · Reduced service | $5.37 | $5.50 | $6.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.14 Median $2.19 Typical High $2.51 | Professional | 53 · Discontinued | $2.14 | $2.19 | $2.51 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.62 Median $1.62 Typical High $1.91 | Professional | 55 · Aftercare only | $1.62 | $1.62 | $1.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.07 Median $1.10 Typical High $1.26 | Professional | 56 · Pre-op care only | $1.07 | $1.10 | $1.26 |
Where Kentucky sits
The same service costs 2.6 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
$9.77
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.