How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $43.65 Median $602.56 Typical High $691.83 | Facility | None | $43.65 | $602.56 | $691.83 |
Aetna Setting Professional Modifier None Typical Low $74.13 Median $602.56 Typical High $691.83 | Professional | None | $74.13 | $602.56 | $691.83 |
Anthem BCBS Setting Professional Modifier None Typical Low $44.67 Median $58.88 Typical High $63.10 | Professional | None | $44.67 | $58.88 | $63.10 |
Cigna Setting Facility Modifier None Typical Low $144.54 Median $457.09 Typical High $1,258.93 | Facility | None | $144.54 | $457.09 | $1,258.93 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $4,168.69 | Professional | None | $125.89 | $125.89 | $4,168.69 |
Molina Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $44.67 | Professional | None | $44.67 | $44.67 | $44.67 |
United Setting Professional Modifier None Typical Low $114.82 Median $125.89 Typical High $125.89 | Professional | None | $114.82 | $125.89 | $125.89 |
4 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 Professional Modifier 52 · Reduced service Typical Low $37.15 Median $302.00 Typical High $346.74 | Professional | 52 · Reduced service | $37.15 | $302.00 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.79 Median $120.23 Typical High $138.04 | Professional | 53 · Discontinued | $14.79 | $120.23 | $138.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $91.20 Typical High $102.33 | Professional | 55 · Aftercare only | $10.96 | $91.20 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $60.26 Typical High $69.18 | Professional | 56 · Pre-op care only | $7.41 | $60.26 | $69.18 |
Where Kentucky sits
The same service costs 26.9 times more in Kansas than in New York. 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· 50th of 51
$58.88
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.