How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). 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 $37.15 Median $57.54 Typical High $74.13 | Facility | None | $37.15 | $57.54 | $74.13 |
Aetna Setting Professional Modifier None Typical Low $37.15 Median $52.48 Typical High $63.10 | Professional | None | $37.15 | $52.48 | $63.10 |
Anthem BCBS Setting Professional Modifier None Typical Low $35.48 Median $47.86 Typical High $63.10 | Professional | None | $35.48 | $47.86 | $63.10 |
Cigna Setting Facility Modifier None Typical Low $61.66 Median $61.66 Typical High $61.66 | Facility | None | $61.66 | $61.66 | $61.66 |
Cigna Setting Professional Modifier None Typical Low $45.71 Median $60.26 Typical High $316.23 | Professional | None | $45.71 | $60.26 | $316.23 |
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 $38.02 Median $54.95 Typical High $70.79 | Professional | None | $38.02 | $54.95 | $70.79 |
6 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 Facility Modifier 52 · Reduced service Typical Low $18.20 Median $28.84 Typical High $37.15 | Facility | 52 · Reduced service | $18.20 | $28.84 | $37.15 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $5.50 Median $8.71 Typical High $10.96 | Facility | 55 · Aftercare only | $5.50 | $8.71 | $10.96 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $3.63 Median $5.75 Typical High $7.41 | Facility | 56 · Pre-op care only | $3.63 | $5.75 | $7.41 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $18.20 Median $24.55 Typical High $31.62 | Professional | 52 · Reduced service | $18.20 | $24.55 | $31.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.50 Median $7.41 Typical High $9.55 | Professional | 55 · Aftercare only | $5.50 | $7.41 | $9.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.63 Median $5.01 Typical High $6.31 | Professional | 56 · Pre-op care only | $3.63 | $5.01 | $6.31 |
Where Kentucky sits
The same service costs 2.3 times more in Alaska 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
$47.86
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.