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 $18.62 Median $34.67 Typical High $42.66 | Facility | None | $18.62 | $34.67 | $42.66 |
Aetna Setting Professional Modifier None Typical Low $18.62 Median $31.62 Typical High $38.02 | Professional | None | $18.62 | $31.62 | $38.02 |
Ambetter Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $30.90 | Professional | None | $30.90 | $30.90 | $30.90 |
Anthem BCBS Setting Professional Modifier None Typical Low $17.78 Median $25.12 Typical High $36.31 | Professional | None | $17.78 | $25.12 | $36.31 |
Cigna Setting Facility Modifier None Typical Low $36.31 Median $36.31 Typical High $36.31 | Facility | None | $36.31 | $36.31 | $36.31 |
Cigna Setting Professional Modifier None Typical Low $26.92 Median $35.48 Typical High $186.21 | Professional | None | $26.92 | $35.48 | $186.21 |
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 $18.62 Median $31.62 Typical High $39.81 | Professional | None | $18.62 | $31.62 | $39.81 |
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 $9.33 Median $17.38 Typical High $21.38 | Facility | 52 · Reduced service | $9.33 | $17.38 | $21.38 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $2.75 Median $5.25 Typical High $6.46 | Facility | 55 · Aftercare only | $2.75 | $5.25 | $6.46 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $1.86 Median $3.47 Typical High $4.27 | Facility | 56 · Pre-op care only | $1.86 | $3.47 | $4.27 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $9.33 Median $15.49 Typical High $18.62 | Professional | 52 · Reduced service | $9.33 | $15.49 | $18.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.75 Median $4.68 Typical High $5.62 | Professional | 55 · Aftercare only | $2.75 | $4.68 | $5.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.86 Median $3.09 Typical High $3.80 | Professional | 56 · Pre-op care only | $1.86 | $3.09 | $3.80 |
Where Kentucky sits
The same service costs 2.6 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
$25.12
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.