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 $8,511.38 Median $8,511.38 Typical High $8,511.38 | Facility | None | $8,511.38 | $8,511.38 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $8,511.38 Median $8,511.38 Typical High $8,709.64 | Professional | None | $8,511.38 | $8,511.38 | $8,709.64 |
Anthem BCBS Setting Facility Modifier None Typical Low $489.78 Median $512.86 Typical High $10,471.29 | Facility | None | $489.78 | $512.86 | $10,471.29 |
Anthem BCBS Setting Professional Modifier None Typical Low $426.58 Median $6,606.93 Typical High $6,606.93 | Professional | None | $426.58 | $6,606.93 | $6,606.93 |
CareSource Setting Facility Modifier None Typical Low $251.19 Median $251.19 Typical High $407.38 | Facility | None | $251.19 | $251.19 | $407.38 |
CareSource Setting Professional Modifier None Typical Low $213.80 Median $251.19 Typical High $354.81 | Professional | None | $213.80 | $251.19 | $354.81 |
Cigna Setting Facility Modifier None Typical Low $8,709.64 Median $10,000.00 Typical High $30,902.95 | Facility | None | $8,709.64 | $10,000.00 | $30,902.95 |
Cigna Setting Professional Modifier None Typical Low $524.81 Median $8,912.51 Typical High $47,863.01 | Professional | None | $524.81 | $8,912.51 | $47,863.01 |
Molina Setting Professional Modifier None Typical Low $3,019.95 Median $3,019.95 Typical High $3,019.95 | Professional | None | $3,019.95 | $3,019.95 | $3,019.95 |
United Setting Professional Modifier None Typical Low $8,709.64 Median $9,332.54 Typical High $9,772.37 | Professional | None | $8,709.64 | $9,332.54 | $9,772.37 |
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 $4,265.80 Median $4,265.80 Typical High $4,365.16 | Professional | 52 · Reduced service | $4,265.80 | $4,265.80 | $4,365.16 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1,698.24 Median $1,698.24 Typical High $1,737.80 | Professional | 53 · Discontinued | $1,698.24 | $1,698.24 | $1,737.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1,258.93 Median $1,258.93 Typical High $1,318.26 | Professional | 55 · Aftercare only | $1,258.93 | $1,258.93 | $1,318.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $851.14 Median $851.14 Typical High $870.96 | Professional | 56 · Pre-op care only | $851.14 | $851.14 | $870.96 |
Where Kentucky sits
The same service costs 26.3 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· 46th of 51
$8,511
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.