How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). 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 $70.79 Median $70.79 Typical High $70.79 | Facility | None | $70.79 | $70.79 | $70.79 |
Aetna Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $70.79 | Professional | None | $70.79 | $70.79 | $70.79 |
Anthem BCBS Setting Facility Modifier None Typical Low $81.28 Median $85.11 Typical High $85.11 | Facility | None | $81.28 | $85.11 | $85.11 |
Anthem BCBS Setting Professional Modifier None Typical Low $53.70 Median $70.79 Typical High $70.79 | Professional | None | $53.70 | $70.79 | $70.79 |
CareSource Setting Facility Modifier None Typical Low $70.79 Median $70.79 Typical High $114.82 | Facility | None | $70.79 | $70.79 | $114.82 |
CareSource Setting Professional Modifier None Typical Low $70.79 Median $75.86 Typical High $100.00 | Professional | None | $70.79 | $75.86 | $100.00 |
Cigna Setting Facility Modifier None Typical Low $70.79 Median $151.36 Typical High $173.78 | Facility | None | $70.79 | $151.36 | $173.78 |
Cigna Setting Professional Modifier None Typical Low $109.65 Median $125.89 Typical High $616.60 | Professional | None | $109.65 | $125.89 | $616.60 |
Molina Setting Professional Modifier None Typical Low $100.00 Median $100.00 Typical High $100.00 | Professional | None | $100.00 | $100.00 | $100.00 |
United Setting Professional Modifier None Typical Low $114.82 Median $125.89 Typical High $125.89 | Professional | None | $114.82 | $125.89 | $125.89 |
4 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 $35.48 Median $35.48 Typical High $35.48 | Professional | 52 · Reduced service | $35.48 | $35.48 | $35.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.13 Median $14.45 Typical High $14.45 | Professional | 53 · Discontinued | $14.13 | $14.45 | $14.45 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.72 Median $10.72 Typical High $10.72 | Professional | 55 · Aftercare only | $10.72 | $10.72 | $10.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.08 Median $7.08 Typical High $7.08 | Professional | 56 · Pre-op care only | $7.08 | $7.08 | $7.08 |
Where Kentucky sits
The same service costs 2.0 times more in North Dakota than in Maryland. 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· 47th of 51
$70.79
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.