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 $26.92 Median $30.20 Typical High $38.02 | Facility | None | $26.92 | $30.20 | $38.02 |
Aetna Setting Professional Modifier None Typical Low $26.30 Median $28.18 Typical High $32.36 | Professional | None | $26.30 | $28.18 | $32.36 |
Anthem BCBS Setting Professional Modifier None Typical Low $19.50 Median $28.18 Typical High $32.36 | Professional | None | $19.50 | $28.18 | $32.36 |
CareSource Setting Facility Modifier None Typical Low $47.86 Median $47.86 Typical High $47.86 | Facility | None | $47.86 | $47.86 | $47.86 |
CareSource Setting Professional Modifier None Typical Low $51.29 Median $58.88 Typical High $75.86 | Professional | None | $51.29 | $58.88 | $75.86 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $66.07 Typical High $66.07 | Facility | None | $66.07 | $66.07 | $66.07 |
Cigna Setting Professional Modifier None Typical Low $19.95 Median $19.95 Typical High $234.42 | Professional | None | $19.95 | $19.95 | $234.42 |
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 $15.85 Median $20.89 Typical High $27.54 | Professional | None | $15.85 | $20.89 | $27.54 |
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 $13.18 Median $14.13 Typical High $15.14 | Professional | 52 · Reduced service | $13.18 | $14.13 | $15.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.25 Median $5.75 Typical High $6.03 | Professional | 53 · Discontinued | $5.25 | $5.75 | $6.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $19.50 Median $21.38 Typical High $22.91 | Professional | 54 · Surgery only | $19.50 | $21.38 | $22.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.89 Median $4.27 Typical High $4.57 | Professional | 55 · Aftercare only | $3.89 | $4.27 | $4.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.63 Median $2.82 Typical High $3.02 | Professional | 56 · Pre-op care only | $2.63 | $2.82 | $3.02 |
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
$28.18
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.