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 $18.62 Median $18.62 Typical High $18.62 | Facility | None | $18.62 | $18.62 | $18.62 |
Aetna Setting Professional Modifier None Typical Low $18.62 Median $18.62 Typical High $18.62 | Professional | None | $18.62 | $18.62 | $18.62 |
Anthem BCBS Setting Facility Modifier None Typical Low $20.42 Median $21.88 Typical High $46.77 | Facility | None | $20.42 | $21.88 | $46.77 |
Anthem BCBS Setting Professional Modifier None Typical Low $18.62 Median $18.62 Typical High $28.18 | Professional | None | $18.62 | $18.62 | $28.18 |
CareSource Setting Facility Modifier None Typical Low $26.30 Median $26.30 Typical High $42.66 | Facility | None | $26.30 | $26.30 | $42.66 |
CareSource Setting Professional Modifier None Typical Low $26.30 Median $27.54 Typical High $38.02 | Professional | None | $26.30 | $27.54 | $38.02 |
Cigna Setting Facility Modifier None Typical Low $20.89 Median $28.84 Typical High $64.57 | Facility | None | $20.89 | $28.84 | $64.57 |
Cigna Setting Professional Modifier None Typical Low $18.62 Median $18.62 Typical High $85.11 | Professional | None | $18.62 | $18.62 | $85.11 |
Molina Setting Professional Modifier None Typical Low $18.62 Median $20.89 Typical High $26.92 | Professional | None | $18.62 | $20.89 | $26.92 |
United Setting Professional Modifier None Typical Low $20.42 Median $21.38 Typical High $22.39 | Professional | None | $20.42 | $21.38 | $22.39 |
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 $9.33 Median $9.33 Typical High $9.33 | Professional | 52 · Reduced service | $9.33 | $9.33 | $9.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.72 Median $3.72 Typical High $3.72 | Professional | 53 · Discontinued | $3.72 | $3.72 | $3.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.75 Median $2.75 Typical High $2.75 | Professional | 55 · Aftercare only | $2.75 | $2.75 | $2.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.86 Median $1.86 Typical High $1.86 | Professional | 56 · Pre-op care only | $1.86 | $1.86 | $1.86 |
Where Kentucky sits
The same service costs 1.8 times more in Hawaii than in Ohio. 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· 34th of 51
$18.62
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.