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 $74.13 Median $89.13 Typical High $151.36 | Facility | None | $74.13 | $89.13 | $151.36 |
Aetna Setting Professional Modifier None Typical Low $69.18 Median $77.62 Typical High $89.13 | Professional | None | $69.18 | $77.62 | $89.13 |
Anthem BCBS Setting Professional Modifier None Typical Low $61.66 Median $75.86 Typical High $102.33 | Professional | None | $61.66 | $75.86 | $102.33 |
CareSource Setting Facility Modifier None Typical Low $95.50 Median $95.50 Typical High $95.50 | Facility | None | $95.50 | $95.50 | $95.50 |
CareSource Setting Professional Modifier None Typical Low $77.62 Median $95.50 Typical High $123.03 | Professional | None | $77.62 | $95.50 | $123.03 |
Cigna Setting Facility Modifier None Typical Low $104.71 Median $104.71 Typical High $104.71 | Facility | None | $104.71 | $104.71 | $104.71 |
Cigna Setting Professional Modifier None Typical Low $79.43 Median $102.33 Typical High $512.86 | Professional | None | $79.43 | $102.33 | $512.86 |
United Setting Professional Modifier None Typical Low $77.62 Median $93.33 Typical High $141.25 | Professional | None | $77.62 | $93.33 | $141.25 |
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 $37.15 Median $44.67 Typical High $75.86 | Facility | 52 · Reduced service | $37.15 | $44.67 | $75.86 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $11.22 Median $13.18 Typical High $22.91 | Facility | 55 · Aftercare only | $11.22 | $13.18 | $22.91 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $7.41 Median $8.91 Typical High $15.14 | Facility | 56 · Pre-op care only | $7.41 | $8.91 | $15.14 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $34.67 Median $38.90 Typical High $44.67 | Professional | 52 · Reduced service | $34.67 | $38.90 | $44.67 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $11.75 Typical High $13.18 | Professional | 55 · Aftercare only | $10.47 | $11.75 | $13.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.08 Median $7.76 Typical High $8.91 | Professional | 56 · Pre-op care only | $7.08 | $7.76 | $8.91 |
Where Kentucky sits
The same service costs 2.6 times more in Alaska than in Kentucky. 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· 51st of 51
$75.86
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.