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 $151.36 Median $245.47 Typical High $794.33 | Facility | None | $151.36 | $245.47 | $794.33 |
Aetna Setting Professional Modifier None Typical Low $154.88 Median $245.47 Typical High $245.47 | Professional | None | $154.88 | $245.47 | $245.47 |
Anthem BCBS Setting Professional Modifier None Typical Low $190.55 Median $223.87 Typical High $229.09 | Professional | None | $190.55 | $223.87 | $229.09 |
CareSource Setting Facility Modifier None Typical Low $223.87 Median $234.42 Typical High $269.15 | Facility | None | $223.87 | $234.42 | $269.15 |
CareSource Setting Professional Modifier None Typical Low $165.96 Median $181.97 Typical High $239.88 | Professional | None | $165.96 | $181.97 | $239.88 |
Cigna Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $144.54 | Professional | None | $144.54 | $144.54 | $144.54 |
Molina Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $44.67 | Professional | None | $44.67 | $44.67 | $44.67 |
5 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 $75.86 Median $123.03 Typical High $123.03 | Professional | 52 · Reduced service | $75.86 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $48.98 Typical High $48.98 | Professional | 53 · Discontinued | $30.90 | $48.98 | $48.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $181.97 Typical High $181.97 | Professional | 54 · Surgery only | $114.82 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $37.15 Typical High $37.15 | Professional | 55 · Aftercare only | $22.91 | $37.15 | $37.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $24.55 Typical High $24.55 | Professional | 56 · Pre-op care only | $15.14 | $24.55 | $24.55 |
Where Kentucky sits
The same service costs 7.6 times more in Nebraska than in West Virginia. 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· 30th of 51
$224
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.