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 $52.48 Median $63.10 Typical High $70.79 | Facility | None | $52.48 | $63.10 | $70.79 |
Aetna Setting Professional Modifier None Typical Low $51.29 Median $63.10 Typical High $93.33 | Professional | None | $51.29 | $63.10 | $93.33 |
Ambetter Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $93.33 | Professional | None | $93.33 | $93.33 | $93.33 |
Anthem BCBS Setting Professional Modifier None Typical Low $52.48 Median $63.10 Typical High $63.10 | Professional | None | $52.48 | $63.10 | $63.10 |
CareSource Setting Facility Modifier None Typical Low $63.10 Median $75.86 Typical High $120.23 | Facility | None | $63.10 | $75.86 | $120.23 |
CareSource Setting Professional Modifier None Typical Low $67.61 Median $93.33 Typical High $123.03 | Professional | None | $67.61 | $93.33 | $123.03 |
Cigna Setting Facility Modifier None Typical Low $102.33 Median $102.33 Typical High $102.33 | Facility | None | $102.33 | $102.33 | $102.33 |
Cigna Setting Professional Modifier None Typical Low $77.62 Median $416.87 Typical High $416.87 | Professional | None | $77.62 | $416.87 | $416.87 |
United Setting Professional Modifier None Typical Low $51.29 Median $58.88 Typical High $100.00 | Professional | None | $51.29 | $58.88 | $100.00 |
3 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 $31.62 Median $35.48 Typical High $41.69 | Facility | 52 · Reduced service | $31.62 | $35.48 | $41.69 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $9.55 Median $10.47 Typical High $12.59 | Facility | 55 · Aftercare only | $9.55 | $10.47 | $12.59 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $6.31 Median $7.08 Typical High $8.32 | Facility | 56 · Pre-op care only | $6.31 | $7.08 | $8.32 |
Where Kentucky sits
The same service costs 2.6 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· 47th of 51
$63.10
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.