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 $56.23 Median $56.23 Typical High $56.23 | Facility | None | $56.23 | $56.23 | $56.23 |
Aetna Setting Professional Modifier None Typical Low $56.23 Median $56.23 Typical High $56.23 | Professional | None | $56.23 | $56.23 | $56.23 |
Anthem BCBS Setting Facility Modifier None Typical Low $61.66 Median $66.07 Typical High $123.03 | Facility | None | $61.66 | $66.07 | $123.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $50.12 Median $56.23 Typical High $70.79 | Professional | None | $50.12 | $56.23 | $70.79 |
CareSource Setting Facility Modifier None Typical Low $52.48 Median $52.48 Typical High $83.18 | Facility | None | $52.48 | $52.48 | $83.18 |
CareSource Setting Professional Modifier None Typical Low $52.48 Median $54.95 Typical High $75.86 | Professional | None | $52.48 | $54.95 | $75.86 |
Cigna Setting Facility Modifier None Typical Low $53.70 Median $70.79 Typical High $194.98 | Facility | None | $53.70 | $70.79 | $194.98 |
Cigna Setting Professional Modifier None Typical Low $53.70 Median $56.23 Typical High $223.87 | Professional | None | $53.70 | $56.23 | $223.87 |
Molina Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $69.18 | Professional | None | $53.70 | $53.70 | $69.18 |
United Setting Professional Modifier None Typical Low $53.70 Median $56.23 Typical High $58.88 | Professional | None | $53.70 | $56.23 | $58.88 |
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 $28.18 Median $28.18 Typical High $28.18 | Professional | 52 · Reduced service | $28.18 | $28.18 | $28.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.22 Median $11.22 Typical High $11.22 | Professional | 53 · Discontinued | $11.22 | $11.22 | $11.22 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.51 Median $8.51 Typical High $8.51 | Professional | 55 · Aftercare only | $8.51 | $8.51 | $8.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.62 Median $5.62 Typical High $5.62 | Professional | 56 · Pre-op care only | $5.62 | $5.62 | $5.62 |
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· 37th of 51
$56.23
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.