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 $165.96 Median $275.42 Typical High $794.33 | Facility | None | $165.96 | $275.42 | $794.33 |
Aetna Setting Professional Modifier None Typical Low $165.96 Median $251.19 Typical High $354.81 | Professional | None | $165.96 | $251.19 | $354.81 |
Anthem BCBS Setting Facility Modifier None Typical Low $575.44 Median $3,019.95 Typical High $3,801.89 | Facility | None | $575.44 | $3,019.95 | $3,801.89 |
Anthem BCBS Setting Professional Modifier None Typical Low $162.18 Median $295.12 Typical High $407.38 | Professional | None | $162.18 | $295.12 | $407.38 |
Cigna Setting Facility Modifier None Typical Low $218.78 Median $218.78 Typical High $1,148.15 | Facility | None | $218.78 | $218.78 | $1,148.15 |
Cigna Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $1,513.56 | Professional | None | $288.40 | $288.40 | $1,513.56 |
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 Facility Modifier None Typical Low $70.79 Median $186.21 Typical High $1,148.15 | Facility | None | $70.79 | $186.21 | $1,148.15 |
United Setting Professional Modifier None Typical Low $181.97 Median $363.08 Typical High $691.83 | Professional | None | $181.97 | $363.08 | $691.83 |
10 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 $83.18 Median $95.50 Typical High $204.17 | Facility | 52 · Reduced service | $83.18 | $95.50 | $204.17 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $33.11 Median $38.02 Typical High $81.28 | Facility | 53 · Discontinued | $33.11 | $38.02 | $81.28 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $125.89 Median $144.54 Typical High $309.03 | Facility | 54 · Surgery only | $125.89 | $144.54 | $309.03 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $25.12 Median $28.84 Typical High $61.66 | Facility | 55 · Aftercare only | $25.12 | $28.84 | $61.66 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $16.60 Median $19.05 Typical High $40.74 | Facility | 56 · Pre-op care only | $16.60 | $19.05 | $40.74 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $83.18 Median $114.82 Typical High $177.83 | Professional | 52 · Reduced service | $83.18 | $114.82 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $45.71 Typical High $70.79 | Professional | 53 · Discontinued | $33.11 | $45.71 | $70.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $125.89 Median $169.82 Typical High $269.15 | Professional | 54 · Surgery only | $125.89 | $169.82 | $269.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $33.88 Typical High $53.70 | Professional | 55 · Aftercare only | $25.12 | $33.88 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $22.91 Typical High $35.48 | Professional | 56 · Pre-op care only | $16.60 | $22.91 | $35.48 |
Where Kentucky sits
The same service costs 2.8 times more in Wisconsin than in Utah. 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· 47th of 51
$295
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.