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 $11.48 Median $12.59 Typical High $22.91 | Facility | None | $11.48 | $12.59 | $22.91 |
Aetna Setting Professional Modifier None Typical Low $11.48 Median $21.38 Typical High $22.91 | Professional | None | $11.48 | $21.38 | $22.91 |
Ambetter Setting Professional Modifier None Typical Low $15.85 Median $15.85 Typical High $15.85 | Professional | None | $15.85 | $15.85 | $15.85 |
Anthem BCBS Setting Professional Modifier None Typical Low $10.47 Median $18.62 Typical High $22.91 | Professional | None | $10.47 | $18.62 | $22.91 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $34.67 Typical High $34.67 | Facility | None | $34.67 | $34.67 | $34.67 |
Cigna Setting Professional Modifier None Typical Low $19.05 Median $23.99 Typical High $123.03 | Professional | None | $19.05 | $23.99 | $123.03 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
United Setting Professional Modifier None Typical Low $12.59 Median $20.42 Typical High $39.81 | Professional | None | $12.59 | $20.42 | $39.81 |
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 $5.75 Median $10.72 Typical High $11.48 | Professional | 52 · Reduced service | $5.75 | $10.72 | $11.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.29 Median $4.27 Typical High $4.57 | Professional | 53 · Discontinued | $2.29 | $4.27 | $4.57 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.74 Median $3.24 Typical High $3.47 | Professional | 55 · Aftercare only | $1.74 | $3.24 | $3.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.15 Median $2.14 Typical High $2.29 | Professional | 56 · Pre-op care only | $1.15 | $2.14 | $2.29 |
Where Kentucky sits
The same service costs 4.1 times more in Wyoming 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
$18.62
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.