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 $26.92 Median $52.48 Typical High $77.62 | Facility | None | $26.92 | $52.48 | $77.62 |
Aetna Setting Professional Modifier None Typical Low $26.92 Median $52.48 Typical High $52.48 | Professional | None | $26.92 | $52.48 | $52.48 |
Anthem BCBS Setting Professional Modifier None Typical Low $70.79 Median $83.18 Typical High $93.33 | Professional | None | $70.79 | $83.18 | $93.33 |
Cigna Setting Facility Modifier None Typical Low $83.18 Median $83.18 Typical High $83.18 | Facility | None | $83.18 | $83.18 | $83.18 |
Cigna Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $295.12 | Professional | None | $52.48 | $52.48 | $295.12 |
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 $60.26 Median $61.66 Typical High $61.66 | Professional | None | $60.26 | $61.66 | $61.66 |
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 $13.49 Median $26.30 Typical High $26.30 | Professional | 52 · Reduced service | $13.49 | $26.30 | $26.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.37 Median $10.47 Typical High $10.72 | Professional | 53 · Discontinued | $5.37 | $10.47 | $10.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.98 Median $7.94 Typical High $7.94 | Professional | 55 · Aftercare only | $3.98 | $7.94 | $7.94 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.69 Median $5.25 Typical High $5.25 | Professional | 56 · Pre-op care only | $2.69 | $5.25 | $5.25 |
Where Kentucky sits
The same service costs 4.6 times more in New York than in North Carolina. 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· 8th of 51
$70.79
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.