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 $19.50 Median $66.07 Typical High $66.07 | Facility | None | $19.50 | $66.07 | $66.07 |
Aetna Setting Professional Modifier None Typical Low $58.88 Median $66.07 Typical High $74.13 | Professional | None | $58.88 | $66.07 | $74.13 |
Anthem BCBS Setting Professional Modifier None Typical Low $57.54 Median $75.86 Typical High $107.15 | Professional | None | $57.54 | $75.86 | $107.15 |
CareSource Setting Facility Modifier None Typical Low $50.12 Median $60.26 Typical High $95.50 | Facility | None | $50.12 | $60.26 | $95.50 |
CareSource Setting Professional Modifier None Typical Low $53.70 Median $74.13 Typical High $95.50 | Professional | None | $53.70 | $74.13 | $95.50 |
Cigna Setting Facility Modifier None Typical Low $117.49 Median $117.49 Typical High $117.49 | Facility | None | $117.49 | $117.49 | $117.49 |
Cigna Setting Professional Modifier None Typical Low $64.57 Median $72.44 Typical High $363.08 | Professional | None | $64.57 | $72.44 | $363.08 |
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 $64.57 Median $75.86 Typical High $102.33 | Professional | None | $64.57 | $75.86 | $102.33 |
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 $29.51 Median $32.36 Typical High $37.15 | Professional | 52 · Reduced service | $29.51 | $32.36 | $37.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $13.18 Typical High $15.14 | Professional | 53 · Discontinued | $12.02 | $13.18 | $15.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.91 Median $9.77 Typical High $11.22 | Professional | 55 · Aftercare only | $8.91 | $9.77 | $11.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.89 Median $6.61 Typical High $7.41 | Professional | 56 · Pre-op care only | $5.89 | $6.61 | $7.41 |
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· 45th of 51
$75.86
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.