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 $41.69 Median $46.77 Typical High $77.62 | Facility | None | $41.69 | $46.77 | $77.62 |
Aetna Setting Professional Modifier None Typical Low $40.74 Median $44.67 Typical High $46.77 | Professional | None | $40.74 | $44.67 | $46.77 |
Anthem BCBS Setting Professional Modifier None Typical Low $30.20 Median $43.65 Typical High $50.12 | Professional | None | $30.20 | $43.65 | $50.12 |
CareSource Setting Facility Modifier None Typical Low $74.13 Median $74.13 Typical High $74.13 | Facility | None | $74.13 | $74.13 | $74.13 |
CareSource Setting Professional Modifier None Typical Low $79.43 Median $91.20 Typical High $117.49 | Professional | None | $79.43 | $91.20 | $117.49 |
Cigna Setting Facility Modifier None Typical Low $102.33 Median $102.33 Typical High $102.33 | Facility | None | $102.33 | $102.33 | $102.33 |
Cigna Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $363.08 | Professional | None | $30.90 | $30.90 | $363.08 |
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 $24.55 Median $32.36 Typical High $42.66 | Professional | None | $24.55 | $32.36 | $42.66 |
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 $20.42 Median $21.88 Typical High $23.44 | Professional | 52 · Reduced service | $20.42 | $21.88 | $23.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.13 Median $8.91 Typical High $9.33 | Professional | 53 · Discontinued | $8.13 | $8.91 | $9.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $30.20 Median $33.11 Typical High $35.48 | Professional | 54 · Surgery only | $30.20 | $33.11 | $35.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.03 Median $6.61 Typical High $7.08 | Professional | 55 · Aftercare only | $6.03 | $6.61 | $7.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.07 Median $4.47 Typical High $4.68 | Professional | 56 · Pre-op care only | $4.07 | $4.47 | $4.68 |
Where Kentucky sits
The same service costs 2.8 times more in Hawaii 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
$43.65
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.