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 $5,011.87 Median $5,248.07 Typical High $5,370.32 | Facility | None | $5,011.87 | $5,248.07 | $5,370.32 |
Aetna Setting Professional Modifier None Typical Low $5,011.87 Median $5,248.07 Typical High $7,762.47 | Professional | None | $5,011.87 | $5,248.07 | $7,762.47 |
Anthem BCBS Setting Professional Modifier None Typical Low $5,888.44 Median $7,943.28 Typical High $9,772.37 | Professional | None | $5,888.44 | $7,943.28 | $9,772.37 |
CareSource Setting Facility Modifier None Typical Low $6,606.93 Median $9,120.11 Typical High $14,791.08 | Facility | None | $6,606.93 | $9,120.11 | $14,791.08 |
CareSource Setting Professional Modifier None Typical Low $10,232.93 Median $12,589.25 Typical High $16,218.10 | Professional | None | $10,232.93 | $12,589.25 | $16,218.10 |
Cigna Setting Facility Modifier None Typical Low $5,623.41 Median $5,623.41 Typical High $14,125.38 | Facility | None | $5,623.41 | $5,623.41 | $14,125.38 |
Cigna Setting Professional Modifier None Typical Low $4,786.30 Median $5,623.41 Typical High $46,773.51 | Professional | None | $4,786.30 | $5,623.41 | $46,773.51 |
Molina Setting Professional Modifier None Typical Low $100.00 Median $100.00 Typical High $100.00 | Professional | None | $100.00 | $100.00 | $100.00 |
United Setting Professional Modifier None Typical Low $3,467.37 Median $5,011.87 Typical High $7,079.46 | Professional | None | $3,467.37 | $5,011.87 | $7,079.46 |
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 $2,511.89 Median $2,630.27 Typical High $3,890.45 | Professional | 52 · Reduced service | $2,511.89 | $2,630.27 | $3,890.45 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1,000.00 Median $1,047.13 Typical High $1,548.82 | Professional | 53 · Discontinued | $1,000.00 | $1,047.13 | $1,548.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $741.31 Median $794.33 Typical High $1,148.15 | Professional | 55 · Aftercare only | $741.31 | $794.33 | $1,148.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $501.19 Median $524.81 Typical High $776.25 | Professional | 56 · Pre-op care only | $501.19 | $524.81 | $776.25 |
Where Kentucky sits
The same service costs 2.6 times more in Montana than in New York. 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· 20th of 51
$6,918
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.