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 $9.33 Median $10.72 Typical High $15.14 | Facility | None | $9.33 | $10.72 | $15.14 |
Aetna Setting Professional Modifier None Typical Low $9.33 Median $10.00 Typical High $10.72 | Professional | None | $9.33 | $10.00 | $10.72 |
Anthem BCBS Setting Professional Modifier None Typical Low $6.92 Median $10.00 Typical High $11.48 | Professional | None | $6.92 | $10.00 | $11.48 |
CareSource Setting Facility Modifier None Typical Low $16.98 Median $16.98 Typical High $16.98 | Facility | None | $16.98 | $16.98 | $16.98 |
CareSource Setting Professional Modifier None Typical Low $18.20 Median $20.89 Typical High $26.92 | Professional | None | $18.20 | $20.89 | $26.92 |
Cigna Setting Facility Modifier None Typical Low $23.44 Median $23.44 Typical High $23.44 | Facility | None | $23.44 | $23.44 | $23.44 |
Cigna Setting Professional Modifier None Typical Low $7.08 Median $7.08 Typical High $83.18 | Professional | None | $7.08 | $7.08 | $83.18 |
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 $5.62 Median $7.41 Typical High $9.77 | Professional | None | $5.62 | $7.41 | $9.77 |
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 $4.68 Median $5.01 Typical High $5.37 | Professional | 52 · Reduced service | $4.68 | $5.01 | $5.37 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.86 Median $2.04 Typical High $2.14 | Professional | 53 · Discontinued | $1.86 | $2.04 | $2.14 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $6.92 Median $7.59 Typical High $8.13 | Professional | 54 · Surgery only | $6.92 | $7.59 | $8.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.38 Median $1.51 Typical High $1.62 | Professional | 55 · Aftercare only | $1.38 | $1.51 | $1.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.93 Median $1.00 Typical High $1.07 | Professional | 56 · Pre-op care only | $0.93 | $1.00 | $1.07 |
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
$10.00
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.