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 $72.44 Median $72.44 Typical High $72.44 | Facility | None | $72.44 | $72.44 | $72.44 |
Aetna Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $74.13 | Professional | None | $72.44 | $72.44 | $74.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $83.18 Median $85.11 Typical High $112.20 | Facility | None | $83.18 | $85.11 | $112.20 |
Anthem BCBS Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $72.44 | Professional | None | $72.44 | $72.44 | $72.44 |
CareSource Setting Facility Modifier None Typical Low $69.18 Median $69.18 Typical High $112.20 | Facility | None | $69.18 | $69.18 | $112.20 |
CareSource Setting Professional Modifier None Typical Low $69.18 Median $72.44 Typical High $97.72 | Professional | None | $69.18 | $72.44 | $97.72 |
Cigna Setting Facility Modifier None Typical Low $83.18 Median $97.72 Typical High $251.19 | Facility | None | $83.18 | $97.72 | $251.19 |
Cigna Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $309.03 | Professional | None | $72.44 | $72.44 | $309.03 |
United Setting Professional Modifier None Typical Low $29.51 Median $74.13 Typical High $74.13 | Professional | None | $29.51 | $74.13 | $74.13 |
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 $36.31 Median $36.31 Typical High $37.15 | Professional | 52 · Reduced service | $36.31 | $36.31 | $37.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.45 Median $14.45 Typical High $14.79 | Professional | 53 · Discontinued | $14.45 | $14.45 | $14.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $10.96 Typical High $10.96 | Professional | 55 · Aftercare only | $10.96 | $10.96 | $10.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.24 Median $7.24 Typical High $7.41 | Professional | 56 · Pre-op care only | $7.24 | $7.24 | $7.41 |
Where Kentucky sits
The same service costs 1.6 times more in Hawaii than in Delaware. 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
$72.44
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.