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 $89.13 Median $91.20 Typical High $138.04 | Facility | None | $89.13 | $91.20 | $138.04 |
Aetna Setting Professional Modifier None Typical Low $89.13 Median $91.20 Typical High $93.33 | Professional | None | $89.13 | $91.20 | $93.33 |
Ambetter Setting Professional Modifier None Typical Low $69.18 Median $79.43 Typical High $117.49 | Professional | None | $69.18 | $79.43 | $117.49 |
Anthem BCBS Setting Professional Modifier None Typical Low $8.13 Median $10.96 Typical High $93.33 | Professional | None | $8.13 | $10.96 | $93.33 |
CareSource Setting Facility Modifier None Typical Low $70.79 Median $89.13 Typical High $141.25 | Facility | None | $70.79 | $89.13 | $141.25 |
CareSource Setting Professional Modifier None Typical Low $89.13 Median $95.50 Typical High $120.23 | Professional | None | $89.13 | $95.50 | $120.23 |
Cigna Setting Facility Modifier None Typical Low $131.83 Median $131.83 Typical High $131.83 | Facility | None | $131.83 | $131.83 | $131.83 |
Cigna Setting Professional Modifier None Typical Low $61.66 Median $83.18 Typical High $467.74 | Professional | None | $61.66 | $83.18 | $467.74 |
Molina Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $44.67 | Professional | None | $44.67 | $44.67 | $44.67 |
United Setting Professional Modifier None Typical Low $74.13 Median $91.20 Typical High $109.65 | Professional | None | $74.13 | $91.20 | $109.65 |
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 $44.67 Median $45.71 Typical High $46.77 | Professional | 52 · Reduced service | $44.67 | $45.71 | $46.77 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.78 Median $18.20 Typical High $18.62 | Professional | 53 · Discontinued | $17.78 | $18.20 | $18.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $13.80 Typical High $13.80 | Professional | 55 · Aftercare only | $13.18 | $13.80 | $13.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.91 Median $9.12 Typical High $9.33 | Professional | 56 · Pre-op care only | $8.91 | $9.12 | $9.33 |
Where Kentucky sits
The same service costs 3.3 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
$69.18
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.