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 $8.71 Median $8.71 Typical High $8.71 | Facility | None | $8.71 | $8.71 | $8.71 |
Aetna Setting Professional Modifier None Typical Low $8.71 Median $8.71 Typical High $9.12 | Professional | None | $8.71 | $8.71 | $9.12 |
Anthem BCBS Setting Facility Modifier None Typical Low $10.72 Median $14.13 Typical High $14.13 | Facility | None | $10.72 | $14.13 | $14.13 |
Anthem BCBS Setting Professional Modifier None Typical Low $10.72 Median $12.02 Typical High $12.02 | Professional | None | $10.72 | $12.02 | $12.02 |
CareSource Setting Facility Modifier None Typical Low $4.79 Median $4.79 Typical High $4.79 | Facility | None | $4.79 | $4.79 | $4.79 |
CareSource Setting Professional Modifier None Typical Low $3.31 Median $3.98 Typical High $5.13 | Professional | None | $3.31 | $3.98 | $5.13 |
Cigna Setting Facility Modifier None Typical Low $9.33 Median $33.88 Typical High $85.11 | Facility | None | $9.33 | $33.88 | $85.11 |
Cigna Setting Professional Modifier None Typical Low $9.33 Median $9.33 Typical High $48.98 | Professional | None | $9.33 | $9.33 | $48.98 |
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 $8.32 Median $9.12 Typical High $10.00 | Professional | None | $8.32 | $9.12 | $10.00 |
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 $4.37 Median $4.37 Typical High $4.57 | Professional | 52 · Reduced service | $4.37 | $4.37 | $4.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.78 Median $1.78 Typical High $1.82 | Professional | 53 · Discontinued | $1.78 | $1.78 | $1.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.32 Median $1.32 Typical High $1.38 | Professional | 55 · Aftercare only | $1.32 | $1.32 | $1.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.87 Median $0.87 Typical High $0.91 | Professional | 56 · Pre-op care only | $0.87 | $0.87 | $0.91 |
Where Kentucky sits
The same service costs 1.8 times more in Alaska than in Montana. 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· 2nd of 51
$12.02
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.