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 $23.44 Median $26.92 Typical High $32.36 | Facility | None | $23.44 | $26.92 | $32.36 |
Aetna Setting Professional Modifier None Typical Low $22.91 Median $25.12 Typical High $26.92 | Professional | None | $22.91 | $25.12 | $26.92 |
Anthem BCBS Setting Professional Modifier None Typical Low $17.38 Median $25.12 Typical High $28.18 | Professional | None | $17.38 | $25.12 | $28.18 |
CareSource Setting Facility Modifier None Typical Low $41.69 Median $41.69 Typical High $41.69 | Facility | None | $41.69 | $41.69 | $41.69 |
CareSource Setting Professional Modifier None Typical Low $44.67 Median $52.48 Typical High $67.61 | Professional | None | $44.67 | $52.48 | $67.61 |
Cigna Setting Facility Modifier None Typical Low $57.54 Median $57.54 Typical High $57.54 | Facility | None | $57.54 | $57.54 | $57.54 |
Cigna Setting Professional Modifier None Typical Low $17.38 Median $17.38 Typical High $204.17 | Professional | None | $17.38 | $17.38 | $204.17 |
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 $13.80 Median $18.20 Typical High $24.55 | Professional | None | $13.80 | $18.20 | $24.55 |
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 $11.48 Median $12.59 Typical High $13.49 | Professional | 52 · Reduced service | $11.48 | $12.59 | $13.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.57 Median $5.01 Typical High $5.37 | Professional | 53 · Discontinued | $4.57 | $5.01 | $5.37 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $17.38 Median $19.05 Typical High $19.95 | Professional | 54 · Surgery only | $17.38 | $19.05 | $19.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.47 Median $3.80 Typical High $3.98 | Professional | 55 · Aftercare only | $3.47 | $3.80 | $3.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.29 Median $2.51 Typical High $2.69 | Professional | 56 · Pre-op care only | $2.29 | $2.51 | $2.69 |
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· 30th of 51
$25.12
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.