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 $23.99 Median $27.54 Typical High $50.12 | Facility | None | $23.99 | $27.54 | $50.12 |
Aetna Setting Professional Modifier None Typical Low $23.44 Median $25.70 Typical High $27.54 | Professional | None | $23.44 | $25.70 | $27.54 |
Ambetter Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $53.70 | Professional | None | $53.70 | $53.70 | $53.70 |
Anthem BCBS Setting Professional Modifier None Typical Low $17.38 Median $25.12 Typical High $28.84 | Professional | None | $17.38 | $25.12 | $28.84 |
CareSource Setting Facility Modifier None Typical Low $42.66 Median $42.66 Typical High $42.66 | Facility | None | $42.66 | $42.66 | $42.66 |
CareSource Setting Professional Modifier None Typical Low $45.71 Median $53.70 Typical High $67.61 | Professional | None | $45.71 | $53.70 | $67.61 |
Cigna Setting Facility Modifier None Typical Low $58.88 Median $58.88 Typical High $58.88 | Facility | None | $58.88 | $58.88 | $58.88 |
Cigna Setting Professional Modifier None Typical Low $17.78 Median $17.78 Typical High $208.93 | Professional | None | $17.78 | $17.78 | $208.93 |
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 $14.13 Median $18.62 Typical High $25.12 | Professional | None | $14.13 | $18.62 | $25.12 |
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 $11.75 Median $12.88 Typical High $13.80 | Professional | 52 · Reduced service | $11.75 | $12.88 | $13.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.68 Median $5.13 Typical High $5.50 | Professional | 53 · Discontinued | $4.68 | $5.13 | $5.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $17.78 Median $19.05 Typical High $20.42 | Professional | 54 · Surgery only | $17.78 | $19.05 | $20.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.55 Median $3.80 Typical High $4.07 | Professional | 55 · Aftercare only | $3.55 | $3.80 | $4.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.34 Median $2.57 Typical High $2.75 | Professional | 56 · Pre-op care only | $2.34 | $2.57 | $2.75 |
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· 32nd 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.