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 $5.75 Median $5.75 Typical High $5.75 | Facility | None | $5.75 | $5.75 | $5.75 |
Aetna Setting Professional Modifier None Typical Low $5.75 Median $5.75 Typical High $5.75 | Professional | None | $5.75 | $5.75 | $5.75 |
Anthem BCBS Setting Facility Modifier None Typical Low $6.17 Median $6.76 Typical High $13.49 | Facility | None | $6.17 | $6.76 | $13.49 |
Anthem BCBS Setting Professional Modifier None Typical Low $5.62 Median $5.75 Typical High $5.75 | Professional | None | $5.62 | $5.75 | $5.75 |
CareSource Setting Facility Modifier None Typical Low $5.75 Median $5.75 Typical High $9.12 | Facility | None | $5.75 | $5.75 | $9.12 |
CareSource Setting Professional Modifier None Typical Low $5.75 Median $6.03 Typical High $8.32 | Professional | None | $5.75 | $6.03 | $8.32 |
Cigna Setting Facility Modifier None Typical Low $5.75 Median $7.76 Typical High $19.95 | Facility | None | $5.75 | $7.76 | $19.95 |
Cigna Setting Professional Modifier None Typical Low $5.50 Median $5.50 Typical High $24.55 | Professional | None | $5.50 | $5.50 | $24.55 |
Molina Setting Professional Modifier None Typical Low $5.75 Median $5.75 Typical High $7.41 | Professional | None | $5.75 | $5.75 | $7.41 |
United Setting Professional Modifier None Typical Low $5.75 Median $6.03 Typical High $6.31 | Professional | None | $5.75 | $6.03 | $6.31 |
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 $2.88 Median $2.88 Typical High $2.88 | Professional | 52 · Reduced service | $2.88 | $2.88 | $2.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.15 Median $1.15 Typical High $1.15 | Professional | 53 · Discontinued | $1.15 | $1.15 | $1.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.85 Median $0.85 Typical High $0.85 | Professional | 55 · Aftercare only | $0.85 | $0.85 | $0.85 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.56 Median $0.56 Typical High $0.56 | Professional | 56 · Pre-op care only | $0.56 | $0.56 | $0.56 |
Where Kentucky sits
The same service costs 1.5 times more in Alaska than in Pennsylvania. 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· 35th of 51
$5.75
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.