How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $4.47 Median $72.44 Typical High $72.44 | Facility | None | $4.47 | $72.44 | $72.44 |
Aetna Setting Professional Modifier None Typical Low $36.31 Median $72.44 Typical High $72.44 | Professional | None | $36.31 | $72.44 | $72.44 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $18.20 Median $36.31 Typical High $36.31 | Professional | 52 · Reduced service | $18.20 | $36.31 | $36.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.24 Median $14.45 Typical High $14.45 | Professional | 53 · Discontinued | $7.24 | $14.45 | $14.45 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.37 Median $10.96 Typical High $10.96 | Professional | 55 · Aftercare only | $5.37 | $10.96 | $10.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $25.70 Median $30.20 Typical High $30.20 | Professional | None | $25.70 | $30.20 | $30.20 |
Cigna Setting Facility Modifier None Typical Low $190.55 Median $190.55 Typical High $190.55 | Facility | None | $190.55 | $190.55 | $190.55 |
Cigna Setting Professional Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $1,071.52 | Professional | None | $1,071.52 | $1,071.52 | $1,071.52 |
Molina Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $44.67 | Professional | None | $44.67 | $44.67 | $44.67 |
1 more rate 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 56 · Pre-op care only Typical Low $3.63 Median $7.24 Typical High $7.24 | Professional | 56 · Pre-op care only | $3.63 | $7.24 | $7.24 |
Where Kentucky sits
The same service costs 35.5 times more in Texas than in Kentucky. 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· 51st of 51
$30.20
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.