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 $208.93 Median $239.88 Typical High $407.38 | Facility | None | $208.93 | $239.88 | $407.38 |
Aetna Setting Professional Modifier None Typical Low $208.93 Median $239.88 Typical High $346.74 | Professional | None | $208.93 | $239.88 | $346.74 |
Anthem BCBS Setting Professional Modifier None Typical Low $16.98 Median $22.91 Typical High $407.38 | Professional | None | $16.98 | $22.91 | $407.38 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $588.84 Typical High $588.84 | Facility | None | $588.84 | $588.84 | $588.84 |
Cigna Setting Professional Modifier None Typical Low $371.54 Median $371.54 Typical High $2,089.30 | Professional | None | $371.54 | $371.54 | $2,089.30 |
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 $190.55 Median $245.47 Typical High $398.11 | Professional | None | $190.55 | $245.47 | $398.11 |
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 $104.71 Median $117.49 Typical High $173.78 | Professional | 52 · Reduced service | $104.71 | $117.49 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $47.86 Typical High $69.18 | Professional | 53 · Discontinued | $41.69 | $47.86 | $69.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $35.48 Typical High $51.29 | Professional | 55 · Aftercare only | $30.90 | $35.48 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $23.99 Typical High $34.67 | Professional | 56 · Pre-op care only | $20.89 | $23.99 | $34.67 |
Where Kentucky sits
The same service costs 17.0 times more in Iowa 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
$37.15
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.