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 $13.18 Median $14.79 Typical High $32.36 | Facility | None | $13.18 | $14.79 | $32.36 |
Aetna Setting Professional Modifier None Typical Low $12.88 Median $14.79 Typical High $18.62 | Professional | None | $12.88 | $14.79 | $18.62 |
Ambetter Setting Professional Modifier None Typical Low $12.02 Median $14.13 Typical High $28.84 | Professional | None | $12.02 | $14.13 | $28.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $9.55 Median $13.80 Typical High $15.85 | Professional | None | $9.55 | $13.80 | $15.85 |
CareSource Setting Facility Modifier None Typical Low $23.44 Median $23.44 Typical High $23.44 | Facility | None | $23.44 | $23.44 | $23.44 |
CareSource Setting Professional Modifier None Typical Low $25.12 Median $28.84 Typical High $37.15 | Professional | None | $25.12 | $28.84 | $37.15 |
Cigna Setting Facility Modifier None Typical Low $32.36 Median $32.36 Typical High $32.36 | Facility | None | $32.36 | $32.36 | $32.36 |
Cigna Setting Professional Modifier None Typical Low $9.77 Median $9.77 Typical High $114.82 | Professional | None | $9.77 | $9.77 | $114.82 |
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 $7.76 Median $10.23 Typical High $13.49 | Professional | None | $7.76 | $10.23 | $13.49 |
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 $6.46 Median $7.08 Typical High $7.41 | Professional | 52 · Reduced service | $6.46 | $7.08 | $7.41 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.57 Median $2.82 Typical High $2.95 | Professional | 53 · Discontinued | $2.57 | $2.82 | $2.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $9.55 Median $10.47 Typical High $11.22 | Professional | 54 · Surgery only | $9.55 | $10.47 | $11.22 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.91 Median $2.09 Typical High $2.24 | Professional | 55 · Aftercare only | $1.91 | $2.09 | $2.24 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.29 Median $1.41 Typical High $1.48 | Professional | 56 · Pre-op care only | $1.29 | $1.41 | $1.48 |
Where Kentucky sits
The same service costs 2.9 times more in Rhode Island 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· 35th of 51
$13.80
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.