How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $81.28 Median $83.18 Typical High $102.33 | Facility | None | $81.28 | $83.18 | $102.33 |
Aetna Setting Professional Modifier None Typical Low $79.43 Median $83.18 Typical High $102.33 | Professional | None | $79.43 | $83.18 | $102.33 |
Ambetter Setting Professional Modifier None Typical Low $95.50 Median $95.50 Typical High $95.50 | Professional | None | $95.50 | $95.50 | $95.50 |
Anthem BCBS Setting Professional Modifier None Typical Low $67.61 Median $91.20 Typical High $102.33 | Professional | None | $67.61 | $91.20 | $102.33 |
CareSource Setting Facility Modifier None Typical Low $66.07 Median $79.43 Typical High $123.03 | Facility | None | $66.07 | $79.43 | $123.03 |
CareSource Setting Professional Modifier None Typical Low $66.07 Median $97.72 Typical High $123.03 | Professional | None | $66.07 | $97.72 | $123.03 |
Cigna Setting Facility Modifier None Typical Low $138.04 Median $138.04 Typical High $138.04 | Facility | None | $138.04 | $138.04 | $138.04 |
Cigna Setting Professional Modifier None Typical Low $79.43 Median $112.20 Typical High $389.05 | Professional | None | $79.43 | $112.20 | $389.05 |
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 $83.18 Median $95.50 Typical High $147.91 | Professional | None | $83.18 | $95.50 | $147.91 |
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 $39.81 Median $40.74 Typical High $42.66 | Professional | 52 · Reduced service | $39.81 | $40.74 | $42.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.85 Median $16.22 Typical High $17.38 | Professional | 53 · Discontinued | $15.85 | $16.22 | $17.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $12.02 Typical High $12.88 | Professional | 55 · Aftercare only | $12.02 | $12.02 | $12.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $8.13 Typical High $8.51 | Professional | 56 · Pre-op care only | $7.94 | $8.13 | $8.51 |
Where Kentucky sits
The same service costs 2.9 times more in Alaska than in Utah. 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· 37th of 51
$91.20
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.