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 $58.88 Median $87.10 Typical High $117.49 | Facility | None | $58.88 | $87.10 | $117.49 |
Aetna Setting Professional Modifier None Typical Low $58.88 Median $85.11 Typical High $100.00 | Professional | None | $58.88 | $85.11 | $100.00 |
Ambetter Setting Professional Modifier None Typical Low $66.07 Median $97.72 Typical High $147.91 | Professional | None | $66.07 | $97.72 | $147.91 |
Anthem BCBS Setting Professional Modifier None Typical Low $63.10 Median $89.13 Typical High $117.49 | Professional | None | $63.10 | $89.13 | $117.49 |
CareSource Setting Facility Modifier None Typical Low $67.61 Median $107.15 Typical High $190.55 | Facility | None | $67.61 | $107.15 | $190.55 |
CareSource Setting Professional Modifier None Typical Low $97.72 Median $100.00 Typical High $131.83 | Professional | None | $97.72 | $100.00 | $131.83 |
Cigna Setting Facility Modifier None Typical Low $89.13 Median $89.13 Typical High $89.13 | Facility | None | $89.13 | $89.13 | $89.13 |
Cigna Setting Professional Modifier None Typical Low $67.61 Median $102.33 Typical High $549.54 | Professional | None | $67.61 | $102.33 | $549.54 |
Molina Setting Professional Modifier None Typical Low $60.26 Median $79.43 Typical High $83.18 | Professional | None | $60.26 | $79.43 | $83.18 |
United Setting Professional Modifier None Typical Low $61.66 Median $89.13 Typical High $112.20 | Professional | None | $61.66 | $89.13 | $112.20 |
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 $29.51 Median $43.65 Typical High $58.88 | Facility | 52 · Reduced service | $29.51 | $43.65 | $58.88 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $8.91 Median $13.18 Typical High $17.38 | Facility | 55 · Aftercare only | $8.91 | $13.18 | $17.38 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $5.89 Median $8.71 Typical High $11.75 | Facility | 56 · Pre-op care only | $5.89 | $8.71 | $11.75 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $29.51 Median $41.69 Typical High $50.12 | Professional | 52 · Reduced service | $29.51 | $41.69 | $50.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.91 Median $12.59 Typical High $14.79 | Professional | 55 · Aftercare only | $8.91 | $12.59 | $14.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.89 Median $8.32 Typical High $10.00 | Professional | 56 · Pre-op care only | $5.89 | $8.32 | $10.00 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $91.20 Median $91.20 Typical High $109.65 | Professional | 25 · Same-day visit | $91.20 | $91.20 | $109.65 |
Where Kentucky sits
The same service costs 2.9 times more in Alaska than in Washington, DC. 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· 41st of 51
$89.13
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.