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 $54.95 Median $138.04 Typical High $851.14 | Facility | None | $54.95 | $138.04 | $851.14 |
Aetna Setting Professional Modifier None Typical Low $54.95 Median $138.04 Typical High $190.55 | Professional | None | $54.95 | $138.04 | $190.55 |
Anthem BCBS Setting Facility Modifier None Typical Low $575.44 Median $3,019.95 Typical High $3,801.89 | Facility | None | $575.44 | $3,019.95 | $3,801.89 |
Anthem BCBS Setting Professional Modifier None Typical Low $56.23 Median $158.49 Typical High $1,000.00 | Professional | None | $56.23 | $158.49 | $1,000.00 |
CareSource Setting Facility Modifier None Typical Low $44.67 Median $53.70 Typical High $85.11 | Facility | None | $44.67 | $53.70 | $85.11 |
CareSource Setting Professional Modifier None Typical Low $51.29 Median $74.13 Typical High $87.10 | Professional | None | $51.29 | $74.13 | $87.10 |
Cigna Setting Facility Modifier None Typical Low $77.62 Median $77.62 Typical High $144.54 | Facility | None | $77.62 | $77.62 | $144.54 |
Cigna Setting Professional Modifier None Typical Low $63.10 Median $151.36 Typical High $954.99 | Professional | None | $63.10 | $151.36 | $954.99 |
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 $60.26 Median $128.82 Typical High $218.78 | Professional | None | $60.26 | $128.82 | $218.78 |
10 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 $27.54 Median $69.18 Typical High $91.20 | Facility | 52 · Reduced service | $27.54 | $69.18 | $91.20 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $10.96 Median $27.54 Typical High $36.31 | Facility | 53 · Discontinued | $10.96 | $27.54 | $36.31 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $40.74 Median $102.33 Typical High $134.90 | Facility | 54 · Surgery only | $40.74 | $102.33 | $134.90 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $8.13 Median $20.42 Typical High $26.92 | Facility | 55 · Aftercare only | $8.13 | $20.42 | $26.92 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $5.50 Median $13.80 Typical High $18.20 | Facility | 56 · Pre-op care only | $5.50 | $13.80 | $18.20 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $27.54 Median $69.18 Typical High $85.11 | Professional | 52 · Reduced service | $27.54 | $69.18 | $85.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.96 Median $27.54 Typical High $33.88 | Professional | 53 · Discontinued | $10.96 | $27.54 | $33.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $40.74 Median $102.33 Typical High $125.89 | Professional | 54 · Surgery only | $40.74 | $102.33 | $125.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.13 Median $20.42 Typical High $25.70 | Professional | 55 · Aftercare only | $8.13 | $20.42 | $25.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.50 Median $13.80 Typical High $16.98 | Professional | 56 · Pre-op care only | $5.50 | $13.80 | $16.98 |
Where Kentucky sits
The same service costs 3.5 times more in Alaska than in Maryland. 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· 38th of 51
$138
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.