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 $2.04 Median $2.34 Typical High $5.89 | Facility | None | $2.04 | $2.34 | $5.89 |
Aetna Setting Professional Modifier None Typical Low $2.04 Median $2.34 Typical High $3.80 | Professional | None | $2.04 | $2.34 | $3.80 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.71 Median $9.77 Typical High $11.48 | Professional | None | $0.71 | $9.77 | $11.48 |
CareSource Setting Professional Modifier None Typical Low $3.72 Median $3.72 Typical High $3.72 | Professional | None | $3.72 | $3.72 | $3.72 |
Cigna Setting Facility Modifier None Typical Low $4.17 Median $13.49 Typical High $26.30 | Facility | None | $4.17 | $13.49 | $26.30 |
Cigna Setting Professional Modifier None Typical Low $3.72 Median $20.89 Typical High $20.89 | Professional | None | $3.72 | $20.89 | $20.89 |
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 $1.62 Median $5.75 Typical High $8.13 | Professional | None | $1.62 | $5.75 | $8.13 |
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 $1.05 Median $1.17 Typical High $1.91 | Professional | 52 · Reduced service | $1.05 | $1.17 | $1.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.41 Median $0.47 Typical High $0.76 | Professional | 53 · Discontinued | $0.41 | $0.47 | $0.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.31 Median $0.35 Typical High $0.56 | Professional | 55 · Aftercare only | $0.31 | $0.35 | $0.56 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.21 Median $0.24 Typical High $0.38 | Professional | 56 · Pre-op care only | $0.21 | $0.24 | $0.38 |
Where Kentucky sits
The same service costs 4.6 times more in Ohio than in Hawaii. 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· 6th of 51
$5.89
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.