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 $21.38 Median $21.38 Typical High $21.38 | Facility | None | $21.38 | $21.38 | $21.38 |
Aetna Setting Professional Modifier None Typical Low $21.38 Median $21.38 Typical High $21.88 | Professional | None | $21.38 | $21.38 | $21.88 |
Anthem BCBS Setting Facility Modifier None Typical Low $25.12 Median $27.54 Typical High $54.95 | Facility | None | $25.12 | $27.54 | $54.95 |
Anthem BCBS Setting Professional Modifier None Typical Low $21.88 Median $23.44 Typical High $23.44 | Professional | None | $21.88 | $23.44 | $23.44 |
CareSource Setting Professional Modifier None Typical Low $22.39 Median $22.39 Typical High $22.39 | Professional | None | $22.39 | $22.39 | $22.39 |
Cigna Setting Facility Modifier None Typical Low $23.44 Median $60.26 Typical High $77.62 | Facility | None | $23.44 | $60.26 | $77.62 |
Cigna Setting Professional Modifier None Typical Low $22.39 Median $22.39 Typical High $120.23 | Professional | None | $22.39 | $22.39 | $120.23 |
Molina Setting Professional Modifier None Typical Low $23.44 Median $23.44 Typical High $30.20 | Professional | None | $23.44 | $23.44 | $30.20 |
United Setting Professional Modifier None Typical Low $21.88 Median $23.44 Typical High $24.55 | Professional | None | $21.88 | $23.44 | $24.55 |
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 $10.47 Median $10.47 Typical High $10.96 | Professional | 52 · Reduced service | $10.47 | $10.47 | $10.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.27 Median $4.27 Typical High $4.37 | Professional | 53 · Discontinued | $4.27 | $4.27 | $4.37 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.16 Median $3.16 Typical High $3.31 | Professional | 55 · Aftercare only | $3.16 | $3.16 | $3.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.14 Median $2.14 Typical High $2.19 | Professional | 56 · Pre-op care only | $2.14 | $2.14 | $2.19 |
Where Kentucky sits
The same service costs 1.5 times more in Alaska 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· 13th of 51
$23.44
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.