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 $35.48 Median $37.15 Typical High $42.66 | Facility | None | $35.48 | $37.15 | $42.66 |
Aetna Setting Professional Modifier None Typical Low $35.48 Median $37.15 Typical High $40.74 | Professional | None | $35.48 | $37.15 | $40.74 |
Anthem BCBS Setting Professional Modifier None Typical Low $9.77 Median $20.42 Typical High $29.51 | Professional | None | $9.77 | $20.42 | $29.51 |
Cigna Setting Facility Modifier None Typical Low $54.95 Median $54.95 Typical High $54.95 | Facility | None | $54.95 | $54.95 | $54.95 |
Cigna Setting Professional Modifier None Typical Low $20.42 Median $37.15 Typical High $194.98 | Professional | None | $20.42 | $37.15 | $194.98 |
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 $22.39 Median $30.20 Typical High $37.15 | Professional | None | $22.39 | $30.20 | $37.15 |
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 $17.78 Median $18.62 Typical High $20.42 | Professional | 52 · Reduced service | $17.78 | $18.62 | $20.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.24 Median $7.41 Typical High $8.13 | Professional | 53 · Discontinued | $7.24 | $7.41 | $8.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.37 Median $5.50 Typical High $6.17 | Professional | 55 · Aftercare only | $5.37 | $5.50 | $6.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.63 Median $3.72 Typical High $4.07 | Professional | 56 · Pre-op care only | $3.63 | $3.72 | $4.07 |
Where Kentucky sits
The same service costs 12.9 times more in Hawaii 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
$29.51
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.