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 $112.20 Median $354.81 Typical High $354.81 | Facility | None | $112.20 | $354.81 | $354.81 |
Aetna Setting Professional Modifier None Typical Low $117.49 Median $354.81 Typical High $354.81 | Professional | None | $117.49 | $354.81 | $354.81 |
Anthem BCBS Setting Professional Modifier None Typical Low $30.90 Median $40.74 Typical High $40.74 | Professional | None | $30.90 | $40.74 | $40.74 |
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 $44.67 Median $44.67 Typical High $44.67 | Professional | None | $44.67 | $44.67 | $44.67 |
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 $57.54 Median $177.83 Typical High $177.83 | Professional | 52 · Reduced service | $57.54 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $70.79 Typical High $70.79 | Professional | 53 · Discontinued | $23.44 | $70.79 | $70.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $53.70 Typical High $53.70 | Professional | 55 · Aftercare only | $17.38 | $53.70 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $35.48 Typical High $35.48 | Professional | 56 · Pre-op care only | $11.75 | $35.48 | $35.48 |
Where Kentucky sits
The same service costs 5.5 times more in North Dakota than in Kentucky. 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· 51st of 51
$40.74
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.