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 $4.68 Median $5.37 Typical High $16.22 | Facility | None | $4.68 | $5.37 | $16.22 |
Aetna Setting Professional Modifier None Typical Low $4.68 Median $5.37 Typical High $6.61 | Professional | None | $4.68 | $5.37 | $6.61 |
Ambetter Setting Professional Modifier None Typical Low $6.92 Median $6.92 Typical High $6.92 | Professional | None | $6.92 | $6.92 | $6.92 |
Anthem BCBS Setting Professional Modifier None Typical Low $3.47 Median $5.01 Typical High $5.75 | Professional | None | $3.47 | $5.01 | $5.75 |
CareSource Setting Facility Modifier None Typical Low $8.51 Median $8.51 Typical High $8.51 | Facility | None | $8.51 | $8.51 | $8.51 |
CareSource Setting Professional Modifier None Typical Low $8.91 Median $10.47 Typical High $13.49 | Professional | None | $8.91 | $10.47 | $13.49 |
Cigna Setting Facility Modifier None Typical Low $11.75 Median $11.75 Typical High $11.75 | Facility | None | $11.75 | $11.75 | $11.75 |
Cigna Setting Professional Modifier None Typical Low $3.47 Median $3.47 Typical High $53.70 | Professional | None | $3.47 | $3.47 | $53.70 |
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 $2.82 Median $3.72 Typical High $4.90 | Professional | None | $2.82 | $3.72 | $4.90 |
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 $2.29 Median $2.57 Typical High $2.69 | Professional | 52 · Reduced service | $2.29 | $2.57 | $2.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.93 Median $1.02 Typical High $1.07 | Professional | 53 · Discontinued | $0.93 | $1.02 | $1.07 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $3.47 Median $3.89 Typical High $4.07 | Professional | 54 · Surgery only | $3.47 | $3.89 | $4.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.69 Median $0.78 Typical High $0.81 | Professional | 55 · Aftercare only | $0.69 | $0.78 | $0.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.46 Median $0.52 Typical High $0.54 | Professional | 56 · Pre-op care only | $0.46 | $0.52 | $0.54 |
Where Kentucky sits
The same service costs 4.1 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· 36th of 51
$5.01
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.