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 $4.57 Median $5.13 Typical High $12.88 | Facility | None | $4.57 | $5.13 | $12.88 |
Aetna Setting Professional Modifier None Typical Low $4.47 Median $5.01 Typical High $5.75 | Professional | None | $4.47 | $5.01 | $5.75 |
Anthem BCBS Setting Professional Modifier None Typical Low $3.39 Median $4.79 Typical High $5.50 | Professional | None | $3.39 | $4.79 | $5.50 |
CareSource Setting Facility Modifier None Typical Low $8.13 Median $8.13 Typical High $8.13 | Facility | None | $8.13 | $8.13 | $8.13 |
CareSource Setting Professional Modifier None Typical Low $8.71 Median $10.00 Typical High $12.88 | Professional | None | $8.71 | $10.00 | $12.88 |
Cigna Setting Facility Modifier None Typical Low $11.22 Median $11.22 Typical High $11.22 | Facility | None | $11.22 | $11.22 | $11.22 |
Cigna Setting Professional Modifier None Typical Low $3.39 Median $3.39 Typical High $41.69 | Professional | None | $3.39 | $3.39 | $41.69 |
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 $2.69 Median $3.55 Typical High $4.79 | Professional | None | $2.69 | $3.55 | $4.79 |
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 $2.24 Median $2.45 Typical High $2.57 | Professional | 52 · Reduced service | $2.24 | $2.45 | $2.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.89 Median $1.00 Typical High $1.05 | Professional | 53 · Discontinued | $0.89 | $1.00 | $1.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $3.31 Median $3.72 Typical High $3.89 | Professional | 54 · Surgery only | $3.31 | $3.72 | $3.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.68 Median $0.74 Typical High $0.78 | Professional | 55 · Aftercare only | $0.68 | $0.74 | $0.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.45 Median $0.50 Typical High $0.52 | Professional | 56 · Pre-op care only | $0.45 | $0.50 | $0.52 |
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· 32nd of 51
$4.79
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.