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 $100.00 Median $117.49 Typical High $141.25 | Facility | None | $100.00 | $117.49 | $141.25 |
Aetna Setting Professional Modifier None Typical Low $100.00 Median $131.83 Typical High $208.93 | Professional | None | $100.00 | $131.83 | $208.93 |
Ambetter Setting Professional Modifier None Typical Low $141.25 Median $158.49 Typical High $165.96 | Professional | None | $141.25 | $158.49 | $165.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $112.20 Median $134.90 Typical High $208.93 | Professional | None | $112.20 | $134.90 | $208.93 |
CareSource Setting Facility Modifier None Typical Low $109.65 Median $147.91 Typical High $204.17 | Facility | None | $109.65 | $147.91 | $204.17 |
CareSource Setting Professional Modifier None Typical Low $128.82 Median $147.91 Typical High $194.98 | Professional | None | $128.82 | $147.91 | $194.98 |
Cigna Setting Facility Modifier None Typical Low $190.55 Median $190.55 Typical High $190.55 | Facility | None | $190.55 | $190.55 | $190.55 |
Cigna Setting Professional Modifier None Typical Low $131.83 Median $234.42 Typical High $660.69 | Professional | None | $131.83 | $234.42 | $660.69 |
Molina Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $134.90 | Professional | None | $107.15 | $107.15 | $134.90 |
United Setting Professional Modifier None Typical Low $138.04 Median $165.96 Typical High $269.15 | Professional | None | $138.04 | $165.96 | $269.15 |
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 $58.88 Median $66.07 Typical High $83.18 | Facility | 52 · Reduced service | $58.88 | $66.07 | $83.18 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $17.78 Median $19.95 Typical High $25.12 | Facility | 55 · Aftercare only | $17.78 | $19.95 | $25.12 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $11.75 Median $13.18 Typical High $16.60 | Facility | 56 · Pre-op care only | $11.75 | $13.18 | $16.60 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $58.88 Median $66.07 Typical High $77.62 | Professional | 52 · Reduced service | $58.88 | $66.07 | $77.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $19.95 Typical High $23.44 | Professional | 55 · Aftercare only | $17.78 | $19.95 | $23.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $13.18 Typical High $15.49 | Professional | 56 · Pre-op care only | $11.75 | $13.18 | $15.49 |
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· 45th of 51
$141
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.