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 $19.05 Median $21.38 Typical High $30.20 | Facility | None | $19.05 | $21.38 | $30.20 |
Aetna Setting Professional Modifier None Typical Low $18.62 Median $20.42 Typical High $21.38 | Professional | None | $18.62 | $20.42 | $21.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $13.80 Median $19.95 Typical High $22.91 | Professional | None | $13.80 | $19.95 | $22.91 |
CareSource Setting Facility Modifier None Typical Low $33.88 Median $33.88 Typical High $33.88 | Facility | None | $33.88 | $33.88 | $33.88 |
CareSource Setting Professional Modifier None Typical Low $36.31 Median $41.69 Typical High $53.70 | Professional | None | $36.31 | $41.69 | $53.70 |
Cigna Setting Facility Modifier None Typical Low $46.77 Median $46.77 Typical High $46.77 | Facility | None | $46.77 | $46.77 | $46.77 |
Cigna Setting Professional Modifier None Typical Low $14.13 Median $14.13 Typical High $165.96 | Professional | None | $14.13 | $14.13 | $165.96 |
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 $11.22 Median $14.79 Typical High $19.50 | Professional | None | $11.22 | $14.79 | $19.50 |
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 $9.33 Median $10.00 Typical High $10.72 | Professional | 52 · Reduced service | $9.33 | $10.00 | $10.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.72 Median $4.07 Typical High $4.27 | Professional | 53 · Discontinued | $3.72 | $4.07 | $4.27 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $13.80 Median $15.14 Typical High $16.22 | Professional | 54 · Surgery only | $13.80 | $15.14 | $16.22 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.75 Median $3.02 Typical High $3.24 | Professional | 55 · Aftercare only | $2.75 | $3.02 | $3.24 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.86 Median $2.04 Typical High $2.14 | Professional | 56 · Pre-op care only | $1.86 | $2.04 | $2.14 |
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
$19.95
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.