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 $229.09 Median $229.09 Typical High $229.09 | Facility | None | $229.09 | $229.09 | $229.09 |
Aetna Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $229.09 | Professional | None | $229.09 | $229.09 | $229.09 |
Anthem BCBS Setting Facility Modifier None Typical Low $245.47 Median $269.15 Typical High $512.86 | Facility | None | $245.47 | $269.15 | $512.86 |
Anthem BCBS Setting Professional Modifier None Typical Low $223.87 Median $229.09 Typical High $229.09 | Professional | None | $223.87 | $229.09 | $229.09 |
CareSource Setting Facility Modifier None Typical Low $218.78 Median $218.78 Typical High $346.74 | Facility | None | $218.78 | $218.78 | $346.74 |
CareSource Setting Professional Modifier None Typical Low $218.78 Median $229.09 Typical High $316.23 | Professional | None | $218.78 | $229.09 | $316.23 |
Cigna Setting Facility Modifier None Typical Low $218.78 Median $295.12 Typical High $794.33 | Facility | None | $218.78 | $295.12 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $933.25 | Professional | None | $229.09 | $229.09 | $933.25 |
Molina Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $288.40 | Professional | None | $288.40 | $288.40 | $288.40 |
United Setting Professional Modifier None Typical Low $223.87 Median $234.42 Typical High $245.47 | Professional | None | $223.87 | $234.42 | $245.47 |
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 $112.20 Median $112.20 Typical High $112.20 | Professional | 52 · Reduced service | $112.20 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $45.71 Typical High $45.71 | Professional | 53 · Discontinued | $45.71 | $45.71 | $45.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $33.88 Typical High $33.88 | Professional | 55 · Aftercare only | $33.88 | $33.88 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $22.91 Typical High $22.91 | Professional | 56 · Pre-op care only | $22.91 | $22.91 | $22.91 |
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· 25th of 51
$229
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.