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 $134.90 Median $162.18 Typical High $223.87 | Facility | None | $134.90 | $162.18 | $223.87 |
Aetna Setting Professional Modifier None Typical Low $134.90 Median $177.83 Typical High $288.40 | Professional | None | $134.90 | $177.83 | $288.40 |
Ambetter Setting Professional Modifier None Typical Low $186.21 Median $186.21 Typical High $263.03 | Professional | None | $186.21 | $186.21 | $263.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $169.82 Median $199.53 Typical High $316.23 | Professional | None | $169.82 | $199.53 | $316.23 |
CareSource Setting Facility Modifier None Typical Low $162.18 Median $218.78 Typical High $309.03 | Facility | None | $162.18 | $218.78 | $309.03 |
CareSource Setting Professional Modifier None Typical Low $190.55 Median $218.78 Typical High $295.12 | Professional | None | $190.55 | $218.78 | $295.12 |
Cigna Setting Facility Modifier None Typical Low $269.15 Median $269.15 Typical High $269.15 | Facility | None | $269.15 | $269.15 | $269.15 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $309.03 Typical High $1,000.00 | Professional | None | $199.53 | $309.03 | $1,000.00 |
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 $186.21 Median $213.80 Typical High $346.74 | Professional | None | $186.21 | $213.80 | $346.74 |
7 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 $81.28 Median $91.20 Typical High $131.83 | Facility | 52 · Reduced service | $81.28 | $91.20 | $131.83 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $24.55 Median $26.92 Typical High $39.81 | Facility | 55 · Aftercare only | $24.55 | $26.92 | $39.81 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $16.22 Median $18.20 Typical High $26.30 | Facility | 56 · Pre-op care only | $16.22 | $18.20 | $26.30 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $81.28 Median $91.20 Typical High $97.72 | Professional | 52 · Reduced service | $81.28 | $91.20 | $97.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $26.92 Typical High $29.51 | Professional | 55 · Aftercare only | $23.99 | $26.92 | $29.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $18.20 Typical High $19.50 | Professional | 56 · Pre-op care only | $16.22 | $18.20 | $19.50 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $234.42 Median $234.42 Typical High $234.42 | Professional | GC · Resident with teaching physician | $234.42 | $234.42 | $234.42 |
Where Kentucky sits
The same service costs 2.4 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· 43rd 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.