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 $33.88 Median $91.20 Typical High $398.11 | Facility | None | $33.88 | $91.20 | $398.11 |
Aetna Setting Professional Modifier None Typical Low $33.11 Median $69.18 Typical High $123.03 | Professional | None | $33.11 | $69.18 | $123.03 |
Ambetter Setting Professional Modifier None Typical Low $32.36 Median $38.02 Typical High $93.33 | Professional | None | $32.36 | $38.02 | $93.33 |
Anthem BCBS Setting Facility Modifier None Typical Low $588.84 Median $1,698.24 Typical High $2,884.03 | Facility | None | $588.84 | $1,698.24 | $2,884.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $21.88 Median $47.86 Typical High $60.26 | Professional | None | $21.88 | $47.86 | $60.26 |
CareSource Setting Facility Modifier None Typical Low $28.18 Median $38.02 Typical High $46.77 | Facility | None | $28.18 | $38.02 | $46.77 |
CareSource Setting Professional Modifier None Typical Low $38.90 Median $87.10 Typical High $123.03 | Professional | None | $38.90 | $87.10 | $123.03 |
Cigna Setting Facility Modifier None Typical Low $53.70 Median $53.70 Typical High $53.70 | Facility | None | $53.70 | $53.70 | $53.70 |
Cigna Setting Professional Modifier None Typical Low $20.42 Median $54.95 Typical High $489.78 | Professional | None | $20.42 | $54.95 | $489.78 |
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 $23.99 Median $42.66 Typical High $83.18 | Professional | None | $23.99 | $42.66 | $83.18 |
5 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 54 · Surgery only Typical Low $25.70 Median $40.74 Typical High $70.79 | Facility | 54 · Surgery only | $25.70 | $40.74 | $70.79 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $5.13 Median $8.13 Typical High $14.13 | Facility | 55 · Aftercare only | $5.13 | $8.13 | $14.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $25.70 Median $40.74 Typical High $70.79 | Professional | 54 · Surgery only | $25.70 | $40.74 | $70.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.13 Median $8.13 Typical High $14.13 | Professional | 55 · Aftercare only | $5.13 | $8.13 | $14.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.39 Median $5.37 Typical High $9.33 | Professional | 56 · Pre-op care only | $3.39 | $5.37 | $9.33 |
Where Kentucky sits
The same service costs 2.8 times more in Alaska than in Kentucky. 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· 51st of 51
$51.29
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.