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 $93.33 Median $120.23 Typical High $158.49 | Facility | None | $93.33 | $120.23 | $158.49 |
Aetna Setting Professional Modifier None Typical Low $93.33 Median $114.82 Typical High $138.04 | Professional | None | $93.33 | $114.82 | $138.04 |
Ambetter Setting Professional Modifier None Typical Low $117.49 Median $158.49 Typical High $204.17 | Professional | None | $117.49 | $158.49 | $204.17 |
Anthem BCBS Setting Professional Modifier None Typical Low $89.13 Median $117.49 Typical High $147.91 | Professional | None | $89.13 | $117.49 | $147.91 |
CareSource Setting Facility Modifier None Typical Low $104.71 Median $158.49 Typical High $281.84 | Facility | None | $104.71 | $158.49 | $281.84 |
CareSource Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $177.83 | Professional | None | $138.04 | $138.04 | $177.83 |
Cigna Setting Facility Modifier None Typical Low $141.25 Median $141.25 Typical High $141.25 | Facility | None | $141.25 | $141.25 | $141.25 |
Cigna Setting Professional Modifier None Typical Low $102.33 Median $141.25 Typical High $758.58 | Professional | None | $102.33 | $141.25 | $758.58 |
Molina Setting Professional Modifier None Typical Low $93.33 Median $117.49 Typical High $123.03 | Professional | None | $93.33 | $117.49 | $123.03 |
United Setting Professional Modifier None Typical Low $97.72 Median $125.89 Typical High $162.18 | Professional | None | $97.72 | $125.89 | $162.18 |
8 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 $46.77 Median $60.26 Typical High $79.43 | Facility | 52 · Reduced service | $46.77 | $60.26 | $79.43 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $13.80 Median $18.20 Typical High $23.99 | Facility | 55 · Aftercare only | $13.80 | $18.20 | $23.99 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $9.33 Median $12.02 Typical High $15.85 | Facility | 56 · Pre-op care only | $9.33 | $12.02 | $15.85 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $46.77 Median $57.54 Typical High $69.18 | Professional | 52 · Reduced service | $46.77 | $57.54 | $69.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $17.38 Typical High $20.42 | Professional | 55 · Aftercare only | $13.80 | $17.38 | $20.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.33 Median $11.48 Typical High $13.80 | Professional | 56 · Pre-op care only | $9.33 | $11.48 | $13.80 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $123.03 Median $147.91 Typical High $204.17 | Professional | 25 · Same-day visit | $123.03 | $147.91 | $204.17 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $181.97 Median $181.97 Typical High $181.97 | Professional | GC · Resident with teaching physician | $181.97 | $181.97 | $181.97 |
Where Kentucky sits
The same service costs 2.7 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· 47th of 51
$123
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.