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 $97.72 Median $128.82 Typical High $154.88 | Facility | None | $97.72 | $128.82 | $154.88 |
Aetna Setting Professional Modifier None Typical Low $97.72 Median $128.82 Typical High $158.49 | Professional | None | $97.72 | $128.82 | $158.49 |
Ambetter Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $213.80 | Professional | None | $154.88 | $154.88 | $213.80 |
Anthem BCBS Setting Professional Modifier None Typical Low $91.20 Median $117.49 Typical High $144.54 | Professional | None | $91.20 | $117.49 | $144.54 |
CareSource Setting Facility Modifier None Typical Low $100.00 Median $125.89 Typical High $173.78 | Facility | None | $100.00 | $125.89 | $173.78 |
CareSource Setting Professional Modifier None Typical Low $147.91 Median $154.88 Typical High $190.55 | Professional | None | $147.91 | $154.88 | $190.55 |
Cigna Setting Facility Modifier None Typical Low $186.21 Median $186.21 Typical High $186.21 | Facility | None | $186.21 | $186.21 | $186.21 |
Cigna Setting Professional Modifier None Typical Low $128.82 Median $151.36 Typical High $776.25 | Professional | None | $128.82 | $151.36 | $776.25 |
Molina Setting Professional Modifier None Typical Low $120.23 Median $128.82 Typical High $134.90 | Professional | None | $120.23 | $128.82 | $134.90 |
United Setting Professional Modifier None Typical Low $131.83 Median $158.49 Typical High $208.93 | Professional | None | $131.83 | $158.49 | $208.93 |
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 $64.57 Median $69.18 Typical High $75.86 | Facility | 52 · Reduced service | $64.57 | $69.18 | $75.86 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $19.50 Median $20.42 Typical High $22.91 | Facility | 55 · Aftercare only | $19.50 | $20.42 | $22.91 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $12.88 Median $13.80 Typical High $15.49 | Facility | 56 · Pre-op care only | $12.88 | $13.80 | $15.49 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $64.57 Median $69.18 Typical High $75.86 | Professional | 52 · Reduced service | $64.57 | $69.18 | $75.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $20.42 Typical High $22.91 | Professional | 55 · Aftercare only | $19.50 | $20.42 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $13.80 Typical High $15.49 | Professional | 56 · Pre-op care only | $12.88 | $13.80 | $15.49 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $154.88 Median $154.88 Typical High $154.88 | Professional | 25 · Same-day visit | $154.88 | $154.88 | $154.88 |
Where Kentucky sits
The same service costs 2.3 times more in Alaska than in Alabama. 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· 49th of 51
$129
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.