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 $25.12 Median $25.12 Typical High $25.12 | Facility | None | $25.12 | $25.12 | $25.12 |
Aetna Setting Professional Modifier None Typical Low $25.12 Median $25.12 Typical High $27.54 | Professional | None | $25.12 | $25.12 | $27.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $26.92 Median $29.51 Typical High $33.11 | Facility | None | $26.92 | $29.51 | $33.11 |
Anthem BCBS Setting Professional Modifier None Typical Low $18.62 Median $25.12 Typical High $25.12 | Professional | None | $18.62 | $25.12 | $25.12 |
CareSource Setting Facility Modifier None Typical Low $21.38 Median $21.38 Typical High $34.67 | Facility | None | $21.38 | $21.38 | $34.67 |
CareSource Setting Professional Modifier None Typical Low $21.38 Median $22.39 Typical High $30.90 | Professional | None | $21.38 | $22.39 | $30.90 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $85.11 Typical High $87.10 | Facility | None | $34.67 | $85.11 | $87.10 |
Cigna Setting Professional Modifier None Typical Low $25.12 Median $25.12 Typical High $25.12 | Professional | None | $25.12 | $25.12 | $25.12 |
Molina Setting Professional Modifier None Typical Low $16.60 Median $22.91 Typical High $30.20 | Professional | None | $16.60 | $22.91 | $30.20 |
United Setting Professional Modifier None Typical Low $16.60 Median $17.78 Typical High $74.13 | Professional | None | $16.60 | $17.78 | $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 $12.30 Median $12.30 Typical High $12.30 | Professional | 52 · Reduced service | $12.30 | $12.30 | $12.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.01 Median $5.01 Typical High $5.01 | Professional | 53 · Discontinued | $5.01 | $5.01 | $5.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.72 Median $3.72 Typical High $3.72 | Professional | 55 · Aftercare only | $3.72 | $3.72 | $3.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.45 Median $2.45 Typical High $2.45 | Professional | 56 · Pre-op care only | $2.45 | $2.45 | $2.45 |
Where Kentucky sits
The same service costs 1.9 times more in Wyoming than in Arizona. 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· 25th of 51
$25.12
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.