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 $190.55 Median $194.98 Typical High $199.53 | Facility | None | $190.55 | $194.98 | $199.53 |
Aetna Setting Professional Modifier None Typical Low $194.98 Median $199.53 Typical High $263.03 | Professional | None | $194.98 | $199.53 | $263.03 |
Ambetter Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $165.96 | Professional | None | $165.96 | $165.96 | $165.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $144.54 Median $169.82 Typical High $204.17 | Professional | None | $144.54 | $169.82 | $204.17 |
CareSource Setting Facility Modifier None Typical Low $158.49 Median $190.55 Typical High $302.00 | Facility | None | $158.49 | $190.55 | $302.00 |
CareSource Setting Professional Modifier None Typical Low $169.82 Median $257.04 Typical High $309.03 | Professional | None | $169.82 | $257.04 | $309.03 |
Cigna Setting Facility Modifier None Typical Low $338.84 Median $338.84 Typical High $338.84 | Facility | None | $338.84 | $338.84 | $338.84 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $229.09 Typical High $1,047.13 | Professional | None | $177.83 | $229.09 | $1,047.13 |
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 Facility Modifier None Typical Low $70.79 Median $186.21 Typical High $1,148.15 | Facility | None | $70.79 | $186.21 | $1,148.15 |
United Setting Professional Modifier None Typical Low $169.82 Median $199.53 Typical High $363.08 | Professional | None | $169.82 | $199.53 | $363.08 |
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 $97.72 Median $100.00 Typical High $109.65 | Professional | 52 · Reduced service | $97.72 | $100.00 | $109.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $40.74 Typical High $43.65 | Professional | 53 · Discontinued | $38.90 | $40.74 | $43.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $30.20 Typical High $32.36 | Professional | 55 · Aftercare only | $29.51 | $30.20 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $19.95 Typical High $21.88 | Professional | 56 · Pre-op care only | $19.50 | $19.95 | $21.88 |
Where Kentucky sits
The same service costs 3.0 times more in Wisconsin 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· 50th of 51
$186
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.