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 $14.45 Median $14.79 Typical High $19.95 | Facility | None | $14.45 | $14.79 | $19.95 |
Aetna Setting Professional Modifier None Typical Low $14.45 Median $14.79 Typical High $15.85 | Professional | None | $14.45 | $14.79 | $15.85 |
Ambetter Setting Professional Modifier None Typical Low $18.20 Median $18.20 Typical High $18.20 | Professional | None | $18.20 | $18.20 | $18.20 |
Anthem BCBS Setting Professional Modifier None Typical Low $11.75 Median $15.49 Typical High $38.02 | Professional | None | $11.75 | $15.49 | $38.02 |
CareSource Setting Facility Modifier None Typical Low $12.30 Median $14.79 Typical High $22.91 | Facility | None | $12.30 | $14.79 | $22.91 |
CareSource Setting Professional Modifier None Typical Low $13.18 Median $16.98 Typical High $22.91 | Professional | None | $13.18 | $16.98 | $22.91 |
Cigna Setting Facility Modifier None Typical Low $21.88 Median $21.88 Typical High $21.88 | Facility | None | $21.88 | $21.88 | $21.88 |
Cigna Setting Professional Modifier None Typical Low $14.79 Median $14.79 Typical High $77.62 | Professional | None | $14.79 | $14.79 | $77.62 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
United Setting Professional Modifier None Typical Low $12.30 Median $15.49 Typical High $21.88 | Professional | None | $12.30 | $15.49 | $21.88 |
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 $7.24 Median $7.41 Typical High $7.94 | Professional | 52 · Reduced service | $7.24 | $7.41 | $7.94 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.88 Median $2.95 Typical High $3.16 | Professional | 53 · Discontinued | $2.88 | $2.95 | $3.16 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.14 Median $2.24 Typical High $2.34 | Professional | 55 · Aftercare only | $2.14 | $2.24 | $2.34 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.45 Median $1.48 Typical High $1.58 | Professional | 56 · Pre-op care only | $1.45 | $1.48 | $1.58 |
Where Kentucky sits
The same service costs 2.8 times more in Alaska than in Louisiana. 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· 41st of 51
$15.14
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.