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 $85.11 Median $85.11 Typical High $85.11 | Facility | None | $85.11 | $85.11 | $85.11 |
Aetna Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $85.11 | Professional | None | $85.11 | $85.11 | $85.11 |
Anthem BCBS Setting Facility Modifier None Typical Low $93.33 Median $102.33 Typical High $190.55 | Facility | None | $93.33 | $102.33 | $190.55 |
Anthem BCBS Setting Professional Modifier None Typical Low $81.28 Median $85.11 Typical High $85.11 | Professional | None | $81.28 | $85.11 | $85.11 |
CareSource Setting Facility Modifier None Typical Low $81.28 Median $81.28 Typical High $131.83 | Facility | None | $81.28 | $81.28 | $131.83 |
CareSource Setting Professional Modifier None Typical Low $81.28 Median $87.10 Typical High $120.23 | Professional | None | $81.28 | $87.10 | $120.23 |
Cigna Setting Facility Modifier None Typical Low $81.28 Median $109.65 Typical High $302.00 | Facility | None | $81.28 | $109.65 | $302.00 |
Cigna Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $346.74 | Professional | None | $85.11 | $85.11 | $346.74 |
Molina Setting Professional Modifier None Typical Low $81.28 Median $85.11 Typical High $107.15 | Professional | None | $81.28 | $85.11 | $107.15 |
United Setting Professional Modifier None Typical Low $81.28 Median $87.10 Typical High $91.20 | Professional | None | $81.28 | $87.10 | $91.20 |
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 $42.66 Median $42.66 Typical High $42.66 | Professional | 52 · Reduced service | $42.66 | $42.66 | $42.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $16.98 Typical High $16.98 | Professional | 53 · Discontinued | $16.98 | $16.98 | $16.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $12.88 Typical High $12.88 | Professional | 55 · Aftercare only | $12.88 | $12.88 | $12.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $8.51 Typical High $8.51 | Professional | 56 · Pre-op care only | $8.51 | $8.51 | $8.51 |
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
$85.11
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.