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 $44.67 Median $120.23 Typical High $158.49 | Facility | None | $44.67 | $120.23 | $158.49 |
Aetna Setting Professional Modifier None Typical Low $44.67 Median $109.65 Typical High $134.90 | Professional | None | $44.67 | $109.65 | $134.90 |
Anthem BCBS Setting Professional Modifier None Typical Low $38.90 Median $100.00 Typical High $144.54 | Professional | None | $38.90 | $100.00 | $144.54 |
CareSource Setting Facility Modifier None Typical Low $34.67 Median $41.69 Typical High $64.57 | Facility | None | $34.67 | $41.69 | $64.57 |
CareSource Setting Professional Modifier None Typical Low $38.90 Median $48.98 Typical High $64.57 | Professional | None | $38.90 | $48.98 | $64.57 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $63.10 Typical High $87.10 | Facility | None | $50.12 | $63.10 | $87.10 |
Cigna Setting Professional Modifier None Typical Low $41.69 Median $117.49 Typical High $630.96 | Professional | None | $41.69 | $117.49 | $630.96 |
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 $39.81 Median $95.50 Typical High $162.18 | Professional | None | $39.81 | $95.50 | $162.18 |
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 $22.39 Median $60.26 Typical High $79.43 | Facility | 52 · Reduced service | $22.39 | $60.26 | $79.43 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $8.91 Median $23.99 Typical High $31.62 | Facility | 53 · Discontinued | $8.91 | $23.99 | $31.62 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $6.76 Median $18.20 Typical High $23.44 | Facility | 55 · Aftercare only | $6.76 | $18.20 | $23.44 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $4.47 Median $12.02 Typical High $15.85 | Facility | 56 · Pre-op care only | $4.47 | $12.02 | $15.85 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $22.39 Median $54.95 Typical High $67.61 | Professional | 52 · Reduced service | $22.39 | $54.95 | $67.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.91 Median $21.88 Typical High $26.92 | Professional | 53 · Discontinued | $8.91 | $21.88 | $26.92 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.76 Median $16.60 Typical High $20.42 | Professional | 55 · Aftercare only | $6.76 | $16.60 | $20.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.47 Median $10.96 Typical High $13.49 | Professional | 56 · Pre-op care only | $4.47 | $10.96 | $13.49 |
Where Kentucky sits
The same service costs 3.5 times more in Wisconsin than in Washington, DC. 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· 41st of 51
$100
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.