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 $2.34 Median $2.69 Typical High $8.13 | Facility | None | $2.34 | $2.69 | $8.13 |
Aetna Setting Professional Modifier None Typical Low $2.34 Median $2.63 Typical High $2.88 | Professional | None | $2.34 | $2.63 | $2.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.74 Median $2.51 Typical High $2.88 | Professional | None | $1.74 | $2.51 | $2.88 |
CareSource Setting Facility Modifier None Typical Low $4.27 Median $4.27 Typical High $4.27 | Facility | None | $4.27 | $4.27 | $4.27 |
CareSource Setting Professional Modifier None Typical Low $4.57 Median $5.25 Typical High $6.76 | Professional | None | $4.57 | $5.25 | $6.76 |
Cigna Setting Facility Modifier None Typical Low $5.89 Median $5.89 Typical High $5.89 | Facility | None | $5.89 | $5.89 | $5.89 |
Cigna Setting Professional Modifier None Typical Low $1.78 Median $1.78 Typical High $26.92 | Professional | None | $1.78 | $1.78 | $26.92 |
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 $1.41 Median $1.86 Typical High $2.45 | Professional | None | $1.41 | $1.86 | $2.45 |
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 $1.17 Median $1.29 Typical High $1.35 | Professional | 52 · Reduced service | $1.17 | $1.29 | $1.35 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.47 Median $0.52 Typical High $0.54 | Professional | 53 · Discontinued | $0.47 | $0.52 | $0.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1.74 Median $1.95 Typical High $2.04 | Professional | 54 · Surgery only | $1.74 | $1.95 | $2.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.35 Median $0.39 Typical High $0.41 | Professional | 55 · Aftercare only | $0.35 | $0.39 | $0.41 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.23 Median $0.25 Typical High $0.27 | Professional | 56 · Pre-op care only | $0.23 | $0.25 | $0.27 |
Where Kentucky sits
The same service costs 4.0 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
$2.51
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.