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 $20.42 Median $22.91 Typical High $35.48 | Facility | None | $20.42 | $22.91 | $35.48 |
Aetna Setting Professional Modifier None Typical Low $19.95 Median $21.88 Typical High $22.91 | Professional | None | $19.95 | $21.88 | $22.91 |
Anthem BCBS Setting Professional Modifier None Typical Low $14.79 Median $21.38 Typical High $24.55 | Professional | None | $14.79 | $21.38 | $24.55 |
CareSource Setting Facility Modifier None Typical Low $36.31 Median $36.31 Typical High $36.31 | Facility | None | $36.31 | $36.31 | $36.31 |
CareSource Setting Professional Modifier None Typical Low $38.90 Median $44.67 Typical High $57.54 | Professional | None | $38.90 | $44.67 | $57.54 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $50.12 | Facility | None | $50.12 | $50.12 | $50.12 |
Cigna Setting Professional Modifier None Typical Low $15.14 Median $15.14 Typical High $177.83 | Professional | None | $15.14 | $15.14 | $177.83 |
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 $12.02 Median $15.85 Typical High $20.89 | Professional | None | $12.02 | $15.85 | $20.89 |
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 $10.00 Median $10.72 Typical High $11.48 | Professional | 52 · Reduced service | $10.00 | $10.72 | $11.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.98 Median $4.37 Typical High $4.57 | Professional | 53 · Discontinued | $3.98 | $4.37 | $4.57 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $14.79 Median $16.22 Typical High $17.38 | Professional | 54 · Surgery only | $14.79 | $16.22 | $17.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.95 Median $3.24 Typical High $3.47 | Professional | 55 · Aftercare only | $2.95 | $3.24 | $3.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.00 Median $2.19 Typical High $2.29 | Professional | 56 · Pre-op care only | $2.00 | $2.19 | $2.29 |
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
$21.38
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.