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 $4.17 Median $4.27 Typical High $6.03 | Facility | None | $4.17 | $4.27 | $6.03 |
Aetna Setting Professional Modifier None Typical Low $4.17 Median $4.27 Typical High $5.62 | Professional | None | $4.17 | $4.27 | $5.62 |
Ambetter Setting Professional Modifier None Typical Low $3.39 Median $4.47 Typical High $5.75 | Professional | None | $3.39 | $4.47 | $5.75 |
Anthem BCBS Setting Professional Modifier None Typical Low $3.16 Median $3.47 Typical High $4.68 | Professional | None | $3.16 | $3.47 | $4.68 |
CareSource Setting Facility Modifier None Typical Low $3.39 Median $3.98 Typical High $5.62 | Facility | None | $3.39 | $3.98 | $5.62 |
CareSource Setting Professional Modifier None Typical Low $3.16 Median $3.98 Typical High $5.37 | Professional | None | $3.16 | $3.98 | $5.37 |
Cigna Setting Facility Modifier None Typical Low $7.76 Median $7.76 Typical High $7.76 | Facility | None | $7.76 | $7.76 | $7.76 |
Cigna Setting Professional Modifier None Typical Low $3.02 Median $4.90 Typical High $23.99 | Professional | None | $3.02 | $4.90 | $23.99 |
Molina Setting Professional Modifier None Typical Low $2.69 Median $33.11 Typical High $33.11 | Professional | None | $2.69 | $33.11 | $33.11 |
United Setting Professional Modifier None Typical Low $4.37 Median $5.13 Typical High $8.91 | Professional | None | $4.37 | $5.13 | $8.91 |
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 Professional Modifier 52 · Reduced service Typical Low $2.04 Median $2.14 Typical High $2.82 | Professional | 52 · Reduced service | $2.04 | $2.14 | $2.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.83 Median $0.85 Typical High $1.12 | Professional | 53 · Discontinued | $0.83 | $0.85 | $1.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.62 Median $0.65 Typical High $0.83 | Professional | 55 · Aftercare only | $0.62 | $0.65 | $0.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.41 Median $0.43 Typical High $0.56 | Professional | 56 · Pre-op care only | $0.41 | $0.43 | $0.56 |
Ambetter Setting Professional Modifier 51 · Multiple procedures Typical Low $4.47 Median $4.47 Typical High $4.47 | Professional | 51 · Multiple procedures | $4.47 | $4.47 | $4.47 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $3.80 Median $4.47 Typical High $6.76 | Professional | 59 · Distinct service | $3.80 | $4.47 | $6.76 |
Ambetter Setting Professional Modifier HO · Master's level Typical Low $3.39 Median $3.39 Typical High $3.39 | Professional | HO · Master's level | $3.39 | $3.39 | $3.39 |
Ambetter Setting Professional Modifier SA · Nurse practitioner Typical Low $4.90 Median $4.90 Typical High $4.90 | Professional | SA · Nurse practitioner | $4.90 | $4.90 | $4.90 |
Where Kentucky sits
The same service costs 2.7 times more in North Dakota than in New Mexico. 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· 49th of 51
$3.98
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.