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 $13.18 Median $15.14 Typical High $36.31 | Facility | None | $13.18 | $15.14 | $36.31 |
Aetna Setting Professional Modifier None Typical Low $12.88 Median $14.45 Typical High $15.14 | Professional | None | $12.88 | $14.45 | $15.14 |
Anthem BCBS Setting Professional Modifier None Typical Low $9.77 Median $14.13 Typical High $15.85 | Professional | None | $9.77 | $14.13 | $15.85 |
CareSource Setting Facility Modifier None Typical Low $23.44 Median $23.44 Typical High $23.44 | Facility | None | $23.44 | $23.44 | $23.44 |
CareSource Setting Professional Modifier None Typical Low $25.12 Median $29.51 Typical High $38.02 | Professional | None | $25.12 | $29.51 | $38.02 |
Cigna Setting Facility Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Facility | None | $33.11 | $33.11 | $33.11 |
Cigna Setting Professional Modifier None Typical Low $9.77 Median $9.77 Typical High $120.23 | Professional | None | $9.77 | $9.77 | $120.23 |
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 $7.94 Median $10.23 Typical High $13.80 | Professional | None | $7.94 | $10.23 | $13.80 |
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 $6.46 Median $7.24 Typical High $7.59 | Professional | 52 · Reduced service | $6.46 | $7.24 | $7.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.57 Median $2.88 Typical High $3.02 | Professional | 53 · Discontinued | $2.57 | $2.88 | $3.02 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $9.77 Median $10.96 Typical High $11.22 | Professional | 54 · Surgery only | $9.77 | $10.96 | $11.22 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.95 Median $2.19 Typical High $2.29 | Professional | 55 · Aftercare only | $1.95 | $2.19 | $2.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.29 Median $1.45 Typical High $1.51 | Professional | 56 · Pre-op care only | $1.29 | $1.45 | $1.51 |
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· 31st of 51
$14.13
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.