How much rates vary
Facilitymedian $933 · 10th to 90th $63 to $2,818Professionalmedian $112 · 10th to 90th $62 to $182
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 $50.12 Median $72.44 Typical High $851.14 | Facility | None | $50.12 | $72.44 | $851.14 |
Aetna Setting Professional Modifier None Typical Low $50.12 Median $72.44 Typical High $173.78 | Professional | None | $50.12 | $72.44 | $173.78 |
Anthem BCBS Setting Facility Modifier None Typical Low $588.84 Median $1,698.24 Typical High $2,884.03 | Facility | None | $588.84 | $1,698.24 | $2,884.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $81.28 Median $128.82 Typical High $151.36 | Professional | None | $81.28 | $128.82 | $151.36 |
CareSource Setting Facility Modifier None Typical Low $70.79 Median $1,258.93 Typical High $2,187.76 | Facility | None | $70.79 | $1,258.93 | $2,187.76 |
CareSource Setting Professional Modifier None Typical Low $125.89 Median $1,584.89 Typical High $2,818.38 | Professional | None | $125.89 | $1,584.89 | $2,818.38 |
Cigna Setting Facility Modifier None Typical Low $58.88 Median $66.07 Typical High $691.83 | Facility | None | $58.88 | $66.07 | $691.83 |
Cigna Setting Professional Modifier None Typical Low $489.78 Median $489.78 Typical High $489.78 | Professional | None | $489.78 | $489.78 | $489.78 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
United Setting Facility Modifier None Typical Low $70.79 Median $186.21 Typical High $1,148.15 | Facility | None | $70.79 | $186.21 | $1,148.15 |
United Setting Professional Modifier None Typical Low $64.57 Median $97.72 Typical High $154.88 | Professional | None | $64.57 | $97.72 | $154.88 |
10 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 Facility Modifier 52 · Reduced service Typical Low $25.12 Median $36.31 Typical High $199.53 | Facility | 52 · Reduced service | $25.12 | $36.31 | $199.53 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $10.00 Median $14.45 Typical High $79.43 | Facility | 53 · Discontinued | $10.00 | $14.45 | $79.43 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $37.15 Median $54.95 Typical High $302.00 | Facility | 54 · Surgery only | $37.15 | $54.95 | $302.00 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $7.59 Median $10.96 Typical High $60.26 | Facility | 55 · Aftercare only | $7.59 | $10.96 | $60.26 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $5.01 Median $7.24 Typical High $39.81 | Facility | 56 · Pre-op care only | $5.01 | $7.24 | $39.81 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $25.12 Median $36.31 Typical High $47.86 | Professional | 52 · Reduced service | $25.12 | $36.31 | $47.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.00 Median $14.45 Typical High $19.05 | Professional | 53 · Discontinued | $10.00 | $14.45 | $19.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $37.15 Median $54.95 Typical High $70.79 | Professional | 54 · Surgery only | $37.15 | $54.95 | $70.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.59 Median $10.96 Typical High $14.13 | Professional | 55 · Aftercare only | $7.59 | $10.96 | $14.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.01 Median $7.24 Typical High $9.55 | Professional | 56 · Pre-op care only | $5.01 | $7.24 | $9.55 |
Where Kentucky sits
The same service costs 3.4 times more in Alaska than in Virginia. 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· 23rd of 51
$126
AK $263VA $77.62
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.