How much rates vary
Facilitymedian $93 · 10th to 90th $47 to $1,479Professionalmedian $93 · 10th to 90th $52 to $162
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 $46.77 Median $89.13 Typical High $794.33 | Facility | None | $46.77 | $89.13 | $794.33 |
Aetna Setting Professional Modifier None Typical Low $46.77 Median $83.18 Typical High $144.54 | Professional | None | $46.77 | $83.18 | $144.54 |
Ambetter Setting Professional Modifier None Typical Low $114.82 Median $114.82 Typical High $114.82 | Professional | None | $114.82 | $114.82 | $114.82 |
Anthem BCBS Setting Facility Modifier None Typical Low $575.44 Median $3,801.89 Typical High $11,220.18 | Facility | None | $575.44 | $3,801.89 | $11,220.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $52.48 Median $93.33 Typical High $138.04 | Professional | None | $52.48 | $93.33 | $138.04 |
CareSource Setting Facility Modifier None Typical Low $20.89 Median $52.48 Typical High $95.50 | Facility | None | $20.89 | $52.48 | $95.50 |
CareSource Setting Professional Modifier None Typical Low $17.38 Median $22.39 Typical High $27.54 | Professional | None | $17.38 | $22.39 | $27.54 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $74.13 Typical High $83.18 | Facility | None | $34.67 | $74.13 | $83.18 |
Cigna Setting Professional Modifier None Typical Low $52.48 Median $107.15 Typical High $549.54 | Professional | None | $52.48 | $107.15 | $549.54 |
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 $60.26 Median $100.00 Typical High $173.78 | Professional | None | $60.26 | $100.00 | $173.78 |
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 $23.44 Median $41.69 Typical High $51.29 | Facility | 52 · Reduced service | $23.44 | $41.69 | $51.29 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $9.33 Median $16.60 Typical High $20.89 | Facility | 53 · Discontinued | $9.33 | $16.60 | $20.89 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $35.48 Median $61.66 Typical High $77.62 | Facility | 54 · Surgery only | $35.48 | $61.66 | $77.62 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $7.08 Median $12.30 Typical High $15.49 | Facility | 55 · Aftercare only | $7.08 | $12.30 | $15.49 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $4.68 Median $8.32 Typical High $10.47 | Facility | 56 · Pre-op care only | $4.68 | $8.32 | $10.47 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $23.44 Median $40.74 Typical High $46.77 | Professional | 52 · Reduced service | $23.44 | $40.74 | $46.77 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.33 Median $16.22 Typical High $18.62 | Professional | 53 · Discontinued | $9.33 | $16.22 | $18.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $35.48 Median $61.66 Typical High $70.79 | Professional | 54 · Surgery only | $35.48 | $61.66 | $70.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.08 Median $12.30 Typical High $14.13 | Professional | 55 · Aftercare only | $7.08 | $12.30 | $14.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.68 Median $8.13 Typical High $9.33 | Professional | 56 · Pre-op care only | $4.68 | $8.13 | $9.33 |
Where Kentucky sits
The same service costs 2.8 times more in Alaska than in Pennsylvania. 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
$93.33
AK $257PA $93.33
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.