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 $107.15 Median $107.15 Typical High $107.15 | Facility | None | $107.15 | $107.15 | $107.15 |
Aetna Setting Professional Modifier None Typical Low $104.71 Median $107.15 Typical High $107.15 | Professional | None | $104.71 | $107.15 | $107.15 |
Anthem BCBS Setting Facility Modifier None Typical Low $120.23 Median $125.89 Typical High $125.89 | Facility | None | $120.23 | $125.89 | $125.89 |
Anthem BCBS Setting Professional Modifier None Typical Low $79.43 Median $107.15 Typical High $112.20 | Professional | None | $79.43 | $107.15 | $112.20 |
CareSource Setting Facility Modifier None Typical Low $107.15 Median $107.15 Typical High $169.82 | Facility | None | $107.15 | $107.15 | $169.82 |
CareSource Setting Professional Modifier None Typical Low $107.15 Median $114.82 Typical High $147.91 | Professional | None | $107.15 | $114.82 | $147.91 |
Cigna Setting Facility Modifier None Typical Low $144.54 Median $158.49 Typical High $309.03 | Facility | None | $144.54 | $158.49 | $309.03 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $616.60 | Professional | None | $125.89 | $125.89 | $616.60 |
Molina Setting Professional Modifier None Typical Low $35.48 Median $51.29 Typical High $147.91 | Professional | None | $35.48 | $51.29 | $147.91 |
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 $52.48 Median $53.70 Typical High $53.70 | Professional | 52 · Reduced service | $52.48 | $53.70 | $53.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $21.38 Typical High $21.38 | Professional | 53 · Discontinued | $20.89 | $21.38 | $21.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $15.85 Typical High $15.85 | Professional | 55 · Aftercare only | $15.85 | $15.85 | $15.85 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $10.72 Typical High $10.72 | Professional | 56 · Pre-op care only | $10.47 | $10.72 | $10.72 |
Where Kentucky sits
The same service costs 6.0 times more in Wyoming than in Montana. 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· 49th of 51
$107
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.