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 $97.72 Median $97.72 Typical High $97.72 | Facility | None | $97.72 | $97.72 | $97.72 |
Aetna Setting Professional Modifier None Typical Low $97.72 Median $97.72 Typical High $97.72 | Professional | None | $97.72 | $97.72 | $97.72 |
Anthem BCBS Setting Facility Modifier None Typical Low $109.65 Median $114.82 Typical High $114.82 | Facility | None | $109.65 | $114.82 | $114.82 |
Anthem BCBS Setting Professional Modifier None Typical Low $74.13 Median $97.72 Typical High $107.15 | Professional | None | $74.13 | $97.72 | $107.15 |
CareSource Setting Facility Modifier None Typical Low $97.72 Median $97.72 Typical High $158.49 | Facility | None | $97.72 | $97.72 | $158.49 |
CareSource Setting Professional Modifier None Typical Low $97.72 Median $104.71 Typical High $138.04 | Professional | None | $97.72 | $104.71 | $138.04 |
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 $97.72 Median $125.89 Typical High $616.60 | Professional | None | $97.72 | $125.89 | $616.60 |
Molina Setting Professional Modifier None Typical Low $141.25 Median $141.25 Typical High $169.82 | Professional | None | $141.25 | $141.25 | $169.82 |
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 $48.98 Median $48.98 Typical High $48.98 | Professional | 52 · Reduced service | $48.98 | $48.98 | $48.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.50 Median $19.50 Typical High $19.50 | Professional | 53 · Discontinued | $19.50 | $19.50 | $19.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.45 Median $14.79 Typical High $14.79 | Professional | 55 · Aftercare only | $14.45 | $14.79 | $14.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.77 Median $9.77 Typical High $9.77 | Professional | 56 · Pre-op care only | $9.77 | $9.77 | $9.77 |
Where Kentucky sits
The same service costs 2.0 times more in Alaska 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· 50th of 51
$97.72
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.