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 $26.30 Median $34.67 Typical High $39.81 | Facility | None | $26.30 | $34.67 | $39.81 |
Aetna Setting Professional Modifier None Typical Low $33.11 Median $37.15 Typical High $41.69 | Professional | None | $33.11 | $37.15 | $41.69 |
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 $13.49 Median $22.39 Typical High $24.55 | Professional | None | $13.49 | $22.39 | $24.55 |
Cigna Setting Facility Modifier None Typical Low $30.90 Median $30.90 Typical High $30.90 | Facility | None | $30.90 | $30.90 | $30.90 |
Cigna Setting Professional Modifier None Typical Low $22.91 Median $29.51 Typical High $151.36 | Professional | None | $22.91 | $29.51 | $151.36 |
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 $20.89 Median $26.30 Typical High $38.90 | Professional | None | $20.89 | $26.30 | $38.90 |
8 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 $13.18 Median $17.38 Typical High $19.95 | Facility | 52 · Reduced service | $13.18 | $17.38 | $19.95 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $5.25 Median $6.92 Typical High $7.94 | Facility | 53 · Discontinued | $5.25 | $6.92 | $7.94 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $3.98 Median $5.13 Typical High $6.03 | Facility | 55 · Aftercare only | $3.98 | $5.13 | $6.03 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $2.63 Median $3.47 Typical High $3.98 | Facility | 56 · Pre-op care only | $2.63 | $3.47 | $3.98 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $16.60 Median $18.20 Typical High $20.42 | Professional | 52 · Reduced service | $16.60 | $18.20 | $20.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.61 Median $7.41 Typical High $8.32 | Professional | 53 · Discontinued | $6.61 | $7.41 | $8.32 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.01 Median $5.50 Typical High $6.17 | Professional | 55 · Aftercare only | $5.01 | $5.50 | $6.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.31 Median $3.72 Typical High $4.17 | Professional | 56 · Pre-op care only | $3.31 | $3.72 | $4.17 |
Where Kentucky sits
The same service costs 3.8 times more in Alaska than in Indiana. 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· 49th of 51
$23.99
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.