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 $281.84 Median $281.84 Typical High $281.84 | Facility | None | $281.84 | $281.84 | $281.84 |
Aetna Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $281.84 | Professional | None | $281.84 | $281.84 | $281.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $302.00 Median $331.13 Typical High $630.96 | Facility | None | $302.00 | $331.13 | $630.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $269.15 Median $281.84 Typical High $281.84 | Professional | None | $269.15 | $281.84 | $281.84 |
CareSource Setting Facility Modifier None Typical Low $257.04 Median $257.04 Typical High $416.87 | Facility | None | $257.04 | $257.04 | $416.87 |
CareSource Setting Professional Modifier None Typical Low $257.04 Median $269.15 Typical High $371.54 | Professional | None | $257.04 | $269.15 | $371.54 |
Cigna Setting Facility Modifier None Typical Low $269.15 Median $354.81 Typical High $977.24 | Facility | None | $269.15 | $354.81 | $977.24 |
Cigna Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $1,148.15 | Professional | None | $281.84 | $281.84 | $1,148.15 |
Molina Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $346.74 | Professional | None | $269.15 | $269.15 | $346.74 |
United Setting Professional Modifier None Typical Low $269.15 Median $281.84 Typical High $302.00 | Professional | None | $269.15 | $281.84 | $302.00 |
5 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 $138.04 Median $138.04 Typical High $138.04 | Professional | 52 · Reduced service | $138.04 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $56.23 Typical High $56.23 | Professional | 53 · Discontinued | $56.23 | $56.23 | $56.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $41.69 Typical High $41.69 | Professional | 55 · Aftercare only | $41.69 | $41.69 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $28.18 Typical High $28.18 | Professional | 56 · Pre-op care only | $28.18 | $28.18 | $28.18 |
Ambetter Setting Professional Modifier JW · Drug discarded Typical Low $281.84 Median $281.84 Typical High $281.84 | Professional | JW · Drug discarded | $281.84 | $281.84 | $281.84 |
Where Kentucky sits
Rates are fairly even across states for this service. 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· 38th of 51
$282
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.