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 $128.82 Median $169.82 Typical High $199.53 | Facility | None | $128.82 | $169.82 | $199.53 |
Aetna Setting Professional Modifier None Typical Low $128.82 Median $169.82 Typical High $199.53 | Professional | None | $128.82 | $169.82 | $199.53 |
Ambetter Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $245.47 | Professional | None | $213.80 | $213.80 | $245.47 |
Anthem BCBS Setting Professional Modifier None Typical Low $120.23 Median $154.88 Typical High $186.21 | Professional | None | $120.23 | $154.88 | $186.21 |
CareSource Setting Facility Modifier None Typical Low $134.90 Median $169.82 Typical High $234.42 | Facility | None | $134.90 | $169.82 | $234.42 |
CareSource Setting Professional Modifier None Typical Low $194.98 Median $199.53 Typical High $251.19 | Professional | None | $194.98 | $199.53 | $251.19 |
Cigna Setting Facility Modifier None Typical Low $251.19 Median $251.19 Typical High $251.19 | Facility | None | $251.19 | $251.19 | $251.19 |
Cigna Setting Professional Modifier None Typical Low $173.78 Median $199.53 Typical High $1,000.00 | Professional | None | $173.78 | $199.53 | $1,000.00 |
Molina Setting Professional Modifier None Typical Low $151.36 Median $165.96 Typical High $173.78 | Professional | None | $151.36 | $165.96 | $173.78 |
United Setting Professional Modifier None Typical Low $169.82 Median $199.53 Typical High $257.04 | Professional | None | $169.82 | $199.53 | $257.04 |
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 $87.10 Median $89.13 Typical High $100.00 | Facility | 52 · Reduced service | $87.10 | $89.13 | $100.00 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $26.30 Median $26.92 Typical High $30.20 | Facility | 55 · Aftercare only | $26.30 | $26.92 | $30.20 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $17.38 Median $18.20 Typical High $19.95 | Facility | 56 · Pre-op care only | $17.38 | $18.20 | $19.95 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $81.28 Median $89.13 Typical High $100.00 | Professional | 52 · Reduced service | $81.28 | $89.13 | $100.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $26.92 Typical High $30.20 | Professional | 55 · Aftercare only | $25.70 | $26.92 | $30.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $18.20 Typical High $19.95 | Professional | 56 · Pre-op care only | $16.98 | $18.20 | $19.95 |
Where Kentucky sits
The same service costs 2.4 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· 47th of 51
$174
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.