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 $9.12 Median $10.47 Typical High $25.70 | Facility | None | $9.12 | $10.47 | $25.70 |
Aetna Setting Professional Modifier None Typical Low $8.91 Median $10.00 Typical High $10.72 | Professional | None | $8.91 | $10.00 | $10.72 |
Anthem BCBS Setting Professional Modifier None Typical Low $6.61 Median $9.55 Typical High $10.96 | Professional | None | $6.61 | $9.55 | $10.96 |
CareSource Setting Facility Modifier None Typical Low $16.22 Median $16.22 Typical High $16.22 | Facility | None | $16.22 | $16.22 | $16.22 |
CareSource Setting Professional Modifier None Typical Low $17.38 Median $20.42 Typical High $25.70 | Professional | None | $17.38 | $20.42 | $25.70 |
Cigna Setting Facility Modifier None Typical Low $22.39 Median $22.39 Typical High $22.39 | Facility | None | $22.39 | $22.39 | $22.39 |
Cigna Setting Professional Modifier None Typical Low $6.76 Median $6.76 Typical High $85.11 | Professional | None | $6.76 | $6.76 | $85.11 |
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 $5.37 Median $7.08 Typical High $9.33 | Professional | None | $5.37 | $7.08 | $9.33 |
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 $4.47 Median $5.01 Typical High $5.13 | Professional | 52 · Reduced service | $4.47 | $5.01 | $5.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.78 Median $1.95 Typical High $2.04 | Professional | 53 · Discontinued | $1.78 | $1.95 | $2.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $6.61 Median $7.41 Typical High $7.76 | Professional | 54 · Surgery only | $6.61 | $7.41 | $7.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.35 Median $1.48 Typical High $1.55 | Professional | 55 · Aftercare only | $1.35 | $1.48 | $1.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.89 Median $1.00 Typical High $1.05 | Professional | 56 · Pre-op care only | $0.89 | $1.00 | $1.05 |
Where Kentucky sits
The same service costs 3.2 times more in Rhode Island 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· 34th of 51
$9.55
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.