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 $51.29 Median $91.20 Typical High $91.20 | Facility | None | $51.29 | $91.20 | $91.20 |
Aetna Setting Professional Modifier None Typical Low $83.18 Median $91.20 Typical High $104.71 | Professional | None | $83.18 | $91.20 | $104.71 |
Anthem BCBS Setting Professional Modifier None Typical Low $81.28 Median $102.33 Typical High $147.91 | Professional | None | $81.28 | $102.33 | $147.91 |
CareSource Setting Facility Modifier None Typical Low $70.79 Median $85.11 Typical High $134.90 | Facility | None | $70.79 | $85.11 | $134.90 |
CareSource Setting Professional Modifier None Typical Low $75.86 Median $104.71 Typical High $134.90 | Professional | None | $75.86 | $104.71 | $134.90 |
Cigna Setting Facility Modifier None Typical Low $165.96 Median $165.96 Typical High $165.96 | Facility | None | $165.96 | $165.96 | $165.96 |
Cigna Setting Professional Modifier None Typical Low $89.13 Median $100.00 Typical High $512.86 | Professional | None | $89.13 | $100.00 | $512.86 |
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 $83.18 Median $104.71 Typical High $141.25 | Professional | None | $83.18 | $104.71 | $141.25 |
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 $41.69 Median $45.71 Typical High $52.48 | Professional | 52 · Reduced service | $41.69 | $45.71 | $52.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $18.20 Typical High $20.89 | Professional | 53 · Discontinued | $16.60 | $18.20 | $20.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $13.80 Typical High $15.85 | Professional | 55 · Aftercare only | $12.59 | $13.80 | $15.85 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $9.12 Typical High $10.47 | Professional | 56 · Pre-op care only | $8.32 | $9.12 | $10.47 |
Where Kentucky sits
The same service costs 3.0 times more in Alaska than in Florida. 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· 46th of 51
$102
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.