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 $446.68 Median $446.68 Typical High $446.68 | Facility | None | $446.68 | $446.68 | $446.68 |
Aetna Setting Professional Modifier None Typical Low $446.68 Median $446.68 Typical High $446.68 | Professional | None | $446.68 | $446.68 | $446.68 |
Anthem BCBS Setting Professional Modifier None Typical Low $338.84 Median $446.68 Typical High $446.68 | Professional | None | $338.84 | $446.68 | $446.68 |
CareSource Setting Facility Modifier None Typical Low $446.68 Median $446.68 Typical High $724.44 | Facility | None | $446.68 | $446.68 | $724.44 |
CareSource Setting Professional Modifier None Typical Low $446.68 Median $478.63 Typical High $630.96 | Professional | None | $446.68 | $478.63 | $630.96 |
Cigna Setting Facility Modifier None Typical Low $144.54 Median $457.09 Typical High $467.74 | Facility | None | $144.54 | $457.09 | $467.74 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $851.14 | Professional | None | $125.89 | $125.89 | $851.14 |
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 $223.87 Median $223.87 Typical High $223.87 | Professional | 52 · Reduced service | $223.87 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $89.13 Typical High $89.13 | Professional | 53 · Discontinued | $89.13 | $89.13 | $89.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $67.61 Typical High $67.61 | Professional | 55 · Aftercare only | $66.07 | $67.61 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $44.67 Typical High $44.67 | Professional | 56 · Pre-op care only | $44.67 | $44.67 | $44.67 |
Where Kentucky sits
The same service costs 10.0 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
$447
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.