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 $6.61 Median $7.41 Typical High $15.85 | Facility | None | $6.61 | $7.41 | $15.85 |
Aetna Setting Professional Modifier None Typical Low $6.46 Median $7.08 Typical High $7.59 | Professional | None | $6.46 | $7.08 | $7.59 |
Anthem BCBS Setting Professional Modifier None Typical Low $4.79 Median $6.92 Typical High $7.94 | Professional | None | $4.79 | $6.92 | $7.94 |
CareSource Setting Facility Modifier None Typical Low $11.75 Median $11.75 Typical High $11.75 | Facility | None | $11.75 | $11.75 | $11.75 |
CareSource Setting Professional Modifier None Typical Low $12.59 Median $14.45 Typical High $18.62 | Professional | None | $12.59 | $14.45 | $18.62 |
Cigna Setting Facility Modifier None Typical Low $16.22 Median $16.22 Typical High $16.22 | Facility | None | $16.22 | $16.22 | $16.22 |
Cigna Setting Professional Modifier None Typical Low $4.90 Median $4.90 Typical High $57.54 | Professional | None | $4.90 | $4.90 | $57.54 |
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 $3.89 Median $5.13 Typical High $6.76 | Professional | None | $3.89 | $5.13 | $6.76 |
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 $3.24 Median $3.47 Typical High $3.72 | Professional | 52 · Reduced service | $3.24 | $3.47 | $3.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.29 Median $1.41 Typical High $1.48 | Professional | 53 · Discontinued | $1.29 | $1.41 | $1.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $4.79 Median $5.25 Typical High $5.62 | Professional | 54 · Surgery only | $4.79 | $5.25 | $5.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.95 Median $1.05 Typical High $1.12 | Professional | 55 · Aftercare only | $0.95 | $1.05 | $1.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.65 Median $0.71 Typical High $0.76 | Professional | 56 · Pre-op care only | $0.65 | $0.71 | $0.76 |
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· 31st of 51
$6.92
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.