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 $17.38 Median $19.95 Typical High $371.54 | Facility | None | $17.38 | $19.95 | $371.54 |
Aetna Setting Professional Modifier None Typical Low $17.38 Median $19.95 Typical High $371.54 | Professional | None | $17.38 | $19.95 | $371.54 |
Ambetter Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $302.00 | Professional | None | $302.00 | $302.00 | $302.00 |
Anthem BCBS Setting Professional Modifier None Typical Low $14.79 Median $100.00 Typical High $134.90 | Professional | None | $14.79 | $100.00 | $134.90 |
CareSource Setting Facility Modifier None Typical Low $14.13 Median $16.98 Typical High $26.92 | Facility | None | $14.13 | $16.98 | $26.92 |
CareSource Setting Professional Modifier None Typical Low $16.22 Median $23.44 Typical High $37.15 | Professional | None | $16.22 | $23.44 | $37.15 |
Cigna Setting Facility Modifier None Typical Low $26.30 Median $26.30 Typical High $26.30 | Facility | None | $26.30 | $26.30 | $26.30 |
Cigna Setting Professional Modifier None Typical Low $10.23 Median $223.87 Typical High $1,905.46 | Professional | None | $10.23 | $223.87 | $1,905.46 |
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 $16.22 Median $67.61 Typical High $288.40 | Professional | None | $16.22 | $67.61 | $288.40 |
8 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 $8.71 Median $10.00 Typical High $186.21 | Facility | 52 · Reduced service | $8.71 | $10.00 | $186.21 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $3.47 Median $3.98 Typical High $74.13 | Facility | 53 · Discontinued | $3.47 | $3.98 | $74.13 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $2.57 Median $3.02 Typical High $56.23 | Facility | 55 · Aftercare only | $2.57 | $3.02 | $56.23 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $1.74 Median $2.00 Typical High $37.15 | Facility | 56 · Pre-op care only | $1.74 | $2.00 | $37.15 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $8.71 Median $10.00 Typical High $186.21 | Professional | 52 · Reduced service | $8.71 | $10.00 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.47 Median $3.98 Typical High $74.13 | Professional | 53 · Discontinued | $3.47 | $3.98 | $74.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.57 Median $3.02 Typical High $56.23 | Professional | 55 · Aftercare only | $2.57 | $3.02 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.74 Median $2.00 Typical High $37.15 | Professional | 56 · Pre-op care only | $1.74 | $2.00 | $37.15 |
Where Kentucky sits
The same service costs 28.2 times more in Hawaii than in Washington, DC. 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· 33rd of 51
$100
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.