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 $38.90 Median $50.12 Typical High $81.28 | Facility | None | $38.90 | $50.12 | $81.28 |
Aetna Setting Professional Modifier None Typical Low $38.90 Median $48.98 Typical High $57.54 | Professional | None | $38.90 | $48.98 | $57.54 |
Ambetter Setting Professional Modifier None Typical Low $47.86 Median $61.66 Typical High $61.66 | Professional | None | $47.86 | $61.66 | $61.66 |
Anthem BCBS Setting Professional Modifier None Typical Low $41.69 Median $54.95 Typical High $72.44 | Professional | None | $41.69 | $54.95 | $72.44 |
CareSource Setting Facility Modifier None Typical Low $35.48 Median $44.67 Typical High $61.66 | Facility | None | $35.48 | $44.67 | $61.66 |
CareSource Setting Professional Modifier None Typical Low $57.54 Median $57.54 Typical High $74.13 | Professional | None | $57.54 | $57.54 | $74.13 |
Cigna Setting Facility Modifier None Typical Low $58.88 Median $58.88 Typical High $58.88 | Facility | None | $58.88 | $58.88 | $58.88 |
Cigna Setting Professional Modifier None Typical Low $45.71 Median $58.88 Typical High $309.03 | Professional | None | $45.71 | $58.88 | $309.03 |
Molina Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $46.77 | Professional | None | $44.67 | $44.67 | $46.77 |
United Setting Professional Modifier None Typical Low $47.86 Median $58.88 Typical High $74.13 | Professional | None | $47.86 | $58.88 | $74.13 |
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 $19.50 Median $25.12 Typical High $40.74 | Facility | 52 · Reduced service | $19.50 | $25.12 | $40.74 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $5.75 Median $7.59 Typical High $12.02 | Facility | 55 · Aftercare only | $5.75 | $7.59 | $12.02 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $3.89 Median $5.01 Typical High $8.13 | Facility | 56 · Pre-op care only | $3.89 | $5.01 | $8.13 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $19.50 Median $23.99 Typical High $28.18 | Professional | 52 · Reduced service | $19.50 | $23.99 | $28.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.75 Median $7.24 Typical High $8.51 | Professional | 55 · Aftercare only | $5.75 | $7.24 | $8.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.89 Median $4.79 Typical High $5.75 | Professional | 56 · Pre-op care only | $3.89 | $4.79 | $5.75 |
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· 37th of 51
$54.95
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.