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 $63.10 Median $75.86 Typical High $134.90 | Facility | None | $63.10 | $75.86 | $134.90 |
Aetna Setting Professional Modifier None Typical Low $63.10 Median $85.11 Typical High $151.36 | Professional | None | $63.10 | $85.11 | $151.36 |
Ambetter Setting Professional Modifier None Typical Low $112.20 Median $112.20 Typical High $112.20 | Professional | None | $112.20 | $112.20 | $112.20 |
Anthem BCBS Setting Professional Modifier None Typical Low $91.20 Median $107.15 Typical High $194.98 | Professional | None | $91.20 | $107.15 | $194.98 |
CareSource Setting Facility Modifier None Typical Low $77.62 Median $104.71 Typical High $144.54 | Facility | None | $77.62 | $104.71 | $144.54 |
CareSource Setting Professional Modifier None Typical Low $91.20 Median $100.00 Typical High $138.04 | Professional | None | $91.20 | $100.00 | $138.04 |
Cigna Setting Facility Modifier None Typical Low $123.03 Median $123.03 Typical High $123.03 | Facility | None | $123.03 | $123.03 | $123.03 |
Cigna Setting Professional Modifier None Typical Low $93.33 Median $190.55 Typical High $602.56 | Professional | None | $93.33 | $190.55 | $602.56 |
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 $112.20 Median $128.82 Typical High $199.53 | Professional | None | $112.20 | $128.82 | $199.53 |
6 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 $38.02 Median $42.66 Typical High $79.43 | Facility | 52 · Reduced service | $38.02 | $42.66 | $79.43 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $11.48 Median $12.88 Typical High $23.99 | Facility | 55 · Aftercare only | $11.48 | $12.88 | $23.99 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $7.59 Median $8.51 Typical High $15.85 | Facility | 56 · Pre-op care only | $7.59 | $8.51 | $15.85 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $38.02 Median $42.66 Typical High $52.48 | Professional | 52 · Reduced service | $38.02 | $42.66 | $52.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.48 Median $12.88 Typical High $15.49 | Professional | 55 · Aftercare only | $11.48 | $12.88 | $15.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $8.51 Typical High $10.47 | Professional | 56 · Pre-op care only | $7.59 | $8.51 | $10.47 |
Where Kentucky sits
The same service costs 2.0 times more in Alaska 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· 44th of 51
$110
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.