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 $79.43 Median $79.43 Typical High $79.43 | Facility | None | $79.43 | $79.43 | $79.43 |
Aetna Setting Professional Modifier None Typical Low $79.43 Median $79.43 Typical High $79.43 | Professional | None | $79.43 | $79.43 | $79.43 |
Anthem BCBS Setting Professional Modifier None Typical Low $60.26 Median $79.43 Typical High $89.13 | Professional | None | $60.26 | $79.43 | $89.13 |
CareSource Setting Facility Modifier None Typical Low $79.43 Median $79.43 Typical High $128.82 | Facility | None | $79.43 | $79.43 | $128.82 |
CareSource Setting Professional Modifier None Typical Low $79.43 Median $85.11 Typical High $112.20 | Professional | None | $79.43 | $85.11 | $112.20 |
Cigna Setting Facility Modifier None Typical Low $144.54 Median $173.78 Typical High $446.68 | Facility | None | $144.54 | $173.78 | $446.68 |
Cigna Setting Professional Modifier None Typical Low $79.43 Median $125.89 Typical High $616.60 | Professional | None | $79.43 | $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 $39.81 Median $39.81 Typical High $39.81 | Professional | 52 · Reduced service | $39.81 | $39.81 | $39.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.85 Median $15.85 Typical High $15.85 | Professional | 53 · Discontinued | $15.85 | $15.85 | $15.85 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $12.02 Typical High $12.02 | Professional | 55 · Aftercare only | $12.02 | $12.02 | $12.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $7.94 Typical High $7.94 | Professional | 56 · Pre-op care only | $7.94 | $7.94 | $7.94 |
Where Kentucky sits
The same service costs 7.2 times more in Hawaii 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
$79.43
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.