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 $28.84 Median $33.11 Typical High $87.10 | Facility | None | $28.84 | $33.11 | $87.10 |
Aetna Setting Professional Modifier None Typical Low $28.18 Median $32.36 Typical High $43.65 | Professional | None | $28.18 | $32.36 | $43.65 |
Ambetter Setting Professional Modifier None Typical Low $30.20 Median $43.65 Typical High $43.65 | Professional | None | $30.20 | $43.65 | $43.65 |
Anthem BCBS Setting Professional Modifier None Typical Low $21.38 Median $30.20 Typical High $34.67 | Professional | None | $21.38 | $30.20 | $34.67 |
CareSource Setting Facility Modifier None Typical Low $51.29 Median $61.66 Typical High $72.44 | Facility | None | $51.29 | $61.66 | $72.44 |
CareSource Setting Professional Modifier None Typical Low $51.29 Median $54.95 Typical High $72.44 | Professional | None | $51.29 | $54.95 | $72.44 |
Cigna Setting Facility Modifier None Typical Low $70.79 Median $70.79 Typical High $70.79 | Facility | None | $70.79 | $70.79 | $70.79 |
Cigna Setting Professional Modifier None Typical Low $21.38 Median $21.38 Typical High $288.40 | Professional | None | $21.38 | $21.38 | $288.40 |
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 $16.98 Median $22.39 Typical High $30.20 | Professional | None | $16.98 | $22.39 | $30.20 |
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 $14.13 Median $15.85 Typical High $16.60 | Professional | 52 · Reduced service | $14.13 | $15.85 | $16.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.62 Median $6.31 Typical High $6.61 | Professional | 53 · Discontinued | $5.62 | $6.31 | $6.61 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $21.38 Median $23.44 Typical High $24.55 | Professional | 54 · Surgery only | $21.38 | $23.44 | $24.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.27 Median $4.68 Typical High $4.90 | Professional | 55 · Aftercare only | $4.27 | $4.68 | $4.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.82 Median $3.16 Typical High $3.31 | Professional | 56 · Pre-op care only | $2.82 | $3.16 | $3.31 |
Where Kentucky sits
The same service costs 2.6 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· 37th of 51
$30.20
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.