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 $33.88 Median $33.88 Typical High $33.88 | Facility | None | $33.88 | $33.88 | $33.88 |
Aetna Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $33.88 | Professional | None | $33.88 | $33.88 | $33.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $25.70 Median $33.88 Typical High $37.15 | Professional | None | $25.70 | $33.88 | $37.15 |
CareSource Setting Facility Modifier None Typical Low $33.88 Median $33.88 Typical High $53.70 | Facility | None | $33.88 | $33.88 | $53.70 |
CareSource Setting Professional Modifier None Typical Low $33.88 Median $36.31 Typical High $47.86 | Professional | None | $33.88 | $36.31 | $47.86 |
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 $30.20 Median $47.86 Typical High $47.86 | Professional | None | $30.20 | $47.86 | $47.86 |
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 $16.98 Median $16.98 Typical High $16.98 | Professional | 52 · Reduced service | $16.98 | $16.98 | $16.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.76 Median $6.76 Typical High $6.76 | Professional | 53 · Discontinued | $6.76 | $6.76 | $6.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.01 Median $5.13 Typical High $5.13 | Professional | 55 · Aftercare only | $5.01 | $5.13 | $5.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.39 Median $3.39 Typical High $3.39 | Professional | 56 · Pre-op care only | $3.39 | $3.39 | $3.39 |
Where Kentucky sits
The same service costs 4.2 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· 46th of 51
$33.88
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.