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 $24.55 Median $28.18 Typical High $46.77 | Facility | None | $24.55 | $28.18 | $46.77 |
Aetna Setting Professional Modifier None Typical Low $23.99 Median $26.92 Typical High $28.18 | Professional | None | $23.99 | $26.92 | $28.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $18.20 Median $26.30 Typical High $29.51 | Professional | None | $18.20 | $26.30 | $29.51 |
CareSource Setting Facility Modifier None Typical Low $43.65 Median $43.65 Typical High $43.65 | Facility | None | $43.65 | $43.65 | $43.65 |
CareSource Setting Professional Modifier None Typical Low $46.77 Median $54.95 Typical High $70.79 | Professional | None | $46.77 | $54.95 | $70.79 |
Cigna Setting Facility Modifier None Typical Low $60.26 Median $60.26 Typical High $60.26 | Facility | None | $60.26 | $60.26 | $60.26 |
Cigna Setting Professional Modifier None Typical Low $18.20 Median $18.20 Typical High $213.80 | Professional | None | $18.20 | $18.20 | $213.80 |
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 $14.45 Median $19.05 Typical High $25.70 | Professional | None | $14.45 | $19.05 | $25.70 |
5 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 $12.02 Median $13.49 Typical High $14.13 | Professional | 52 · Reduced service | $12.02 | $13.49 | $14.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.79 Median $5.37 Typical High $5.62 | Professional | 53 · Discontinued | $4.79 | $5.37 | $5.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $18.20 Median $19.95 Typical High $20.89 | Professional | 54 · Surgery only | $18.20 | $19.95 | $20.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.63 Median $4.07 Typical High $4.27 | Professional | 55 · Aftercare only | $3.63 | $4.07 | $4.27 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.40 Median $2.69 Typical High $2.82 | Professional | 56 · Pre-op care only | $2.40 | $2.69 | $2.82 |
Where Kentucky sits
The same service costs 2.7 times more in Hawaii 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· 32nd of 51
$26.30
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.