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 $87.10 Median $169.82 Typical High $851.14 | Facility | None | $87.10 | $169.82 | $851.14 |
Aetna Setting Professional Modifier None Typical Low $87.10 Median $169.82 Typical High $251.19 | Professional | None | $87.10 | $169.82 | $251.19 |
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 $95.50 Median $234.42 Typical High $1,000.00 | Professional | None | $95.50 | $234.42 | $1,000.00 |
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 $83.18 Median $112.20 Typical High $138.04 | Professional | None | $83.18 | $112.20 | $138.04 |
Cigna Setting Facility Modifier None Typical Low $123.03 Median $123.03 Typical High $234.42 | Facility | None | $123.03 | $123.03 | $234.42 |
Cigna Setting Professional Modifier None Typical Low $102.33 Median $213.80 Typical High $1,348.96 | Professional | None | $102.33 | $213.80 | $1,348.96 |
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 $104.71 Median $194.98 Typical High $316.23 | Professional | None | $104.71 | $194.98 | $316.23 |
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 $43.65 Median $85.11 Typical High $125.89 | Facility | 52 · Reduced service | $43.65 | $85.11 | $125.89 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $17.38 Median $34.67 Typical High $50.12 | Facility | 53 · Discontinued | $17.38 | $34.67 | $50.12 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $64.57 Median $128.82 Typical High $190.55 | Facility | 54 · Surgery only | $64.57 | $128.82 | $190.55 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $12.88 Median $25.70 Typical High $38.02 | Facility | 55 · Aftercare only | $12.88 | $25.70 | $38.02 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $8.71 Median $16.98 Typical High $25.12 | Facility | 56 · Pre-op care only | $8.71 | $16.98 | $25.12 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $43.65 Median $85.11 Typical High $114.82 | Professional | 52 · Reduced service | $43.65 | $85.11 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.38 Median $34.67 Typical High $46.77 | Professional | 53 · Discontinued | $17.38 | $34.67 | $46.77 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $64.57 Median $128.82 Typical High $173.78 | Professional | 54 · Surgery only | $64.57 | $128.82 | $173.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $25.70 Typical High $34.67 | Professional | 55 · Aftercare only | $12.88 | $25.70 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $16.98 Typical High $22.91 | Professional | 56 · Pre-op care only | $8.71 | $16.98 | $22.91 |
Where Kentucky sits
The same service costs 3.4 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· 36th of 51
$200
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.