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 $660.69 Median $660.69 Typical High $660.69 | Facility | None | $660.69 | $660.69 | $660.69 |
Aetna Setting Professional Modifier None Typical Low $645.65 Median $660.69 Typical High $660.69 | Professional | None | $645.65 | $660.69 | $660.69 |
Anthem BCBS Setting Professional Modifier None Typical Low $489.78 Median $660.69 Typical High $660.69 | Professional | None | $489.78 | $660.69 | $660.69 |
CareSource Setting Facility Modifier None Typical Low $660.69 Median $660.69 Typical High $1,047.13 | Facility | None | $660.69 | $660.69 | $1,047.13 |
CareSource Setting Professional Modifier None Typical Low $660.69 Median $707.95 Typical High $912.01 | Professional | None | $660.69 | $707.95 | $912.01 |
Cigna Setting Facility Modifier None Typical Low $144.54 Median $457.09 Typical High $707.95 | Facility | None | $144.54 | $457.09 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $1,258.93 | Professional | None | $125.89 | $125.89 | $1,258.93 |
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 $323.59 Median $331.13 Typical High $331.13 | Professional | 52 · Reduced service | $323.59 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $131.83 Typical High $131.83 | Professional | 53 · Discontinued | $128.82 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $97.72 Typical High $97.72 | Professional | 55 · Aftercare only | $97.72 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $66.07 Typical High $66.07 | Professional | 56 · Pre-op care only | $64.57 | $66.07 | $66.07 |
Where Kentucky sits
The same service costs 12.6 times more in Wyoming than in North Carolina. 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· 12th of 51
$661
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.