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 $3.47 Median $102.33 Typical High $102.33 | Facility | None | $3.47 | $102.33 | $102.33 |
Aetna Setting Professional Modifier None Typical Low $81.28 Median $102.33 Typical High $102.33 | Professional | None | $81.28 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $40.74 Median $50.12 Typical High $50.12 | Professional | 52 · Reduced service | $40.74 | $50.12 | $50.12 |
Anthem BCBS Setting Professional Modifier None Typical Low $489.78 Median $645.65 Typical High $645.65 | Professional | None | $489.78 | $645.65 | $645.65 |
Cigna Setting Facility Modifier None Typical Low $181.97 Median $181.97 Typical High $181.97 | Facility | None | $181.97 | $181.97 | $181.97 |
Cigna Setting Professional Modifier None Typical Low $56.23 Median $56.23 Typical High $58.88 | Professional | None | $56.23 | $56.23 | $58.88 |
Molina Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $44.67 | Professional | None | $44.67 | $44.67 | $44.67 |
United Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $61.66 | Professional | None | $58.88 | $58.88 | $61.66 |
3 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 53 · Discontinued Typical Low $16.22 Median $20.42 Typical High $20.42 | Professional | 53 · Discontinued | $16.22 | $20.42 | $20.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $15.14 Typical High $15.14 | Professional | 55 · Aftercare only | $12.02 | $15.14 | $15.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.13 Median $10.00 Typical High $10.00 | Professional | 56 · Pre-op care only | $8.13 | $10.00 | $10.00 |
Where Kentucky sits
The same service costs 13.8 times more in Indiana than in Pennsylvania. 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· 2nd of 51
$550
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.