How much rates vary
Facilitymedian $110 · 10th to 90th $21 to $1,862Professionalmedian $35 · 10th to 90th $21 to $76
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 $19.05 Median $66.07 Typical High $851.14 | Facility | None | $19.05 | $66.07 | $851.14 |
Aetna Setting Professional Modifier None Typical Low $19.05 Median $50.12 Typical High $93.33 | Professional | None | $19.05 | $50.12 | $93.33 |
Ambetter Setting Professional Modifier None Typical Low $24.55 Median $24.55 Typical High $24.55 | Professional | None | $24.55 | $24.55 | $24.55 |
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 $20.89 Median $33.88 Typical High $44.67 | Professional | None | $20.89 | $33.88 | $44.67 |
CareSource Setting Facility Modifier None Typical Low $20.42 Median $524.81 Typical High $933.25 | Facility | None | $20.42 | $524.81 | $933.25 |
CareSource Setting Professional Modifier None Typical Low $25.12 Median $70.79 Typical High $100.00 | Professional | None | $25.12 | $70.79 | $100.00 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $35.48 Typical High $75.86 | Facility | None | $34.67 | $35.48 | $75.86 |
Cigna Setting Professional Modifier None Typical Low $20.89 Median $58.88 Typical High $389.05 | Professional | None | $20.89 | $58.88 | $389.05 |
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 $25.12 Median $47.86 Typical High $87.10 | Professional | None | $25.12 | $47.86 | $87.10 |
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 $9.55 Median $26.30 Typical High $37.15 | Facility | 52 · Reduced service | $9.55 | $26.30 | $37.15 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $3.80 Median $10.72 Typical High $14.79 | Facility | 53 · Discontinued | $3.80 | $10.72 | $14.79 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $14.45 Median $39.81 Typical High $54.95 | Facility | 54 · Surgery only | $14.45 | $39.81 | $54.95 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $2.88 Median $7.94 Typical High $11.22 | Facility | 55 · Aftercare only | $2.88 | $7.94 | $11.22 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $1.91 Median $5.37 Typical High $7.41 | Facility | 56 · Pre-op care only | $1.91 | $5.37 | $7.41 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $9.55 Median $22.91 Typical High $37.15 | Professional | 52 · Reduced service | $9.55 | $22.91 | $37.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.80 Median $9.12 Typical High $14.79 | Professional | 53 · Discontinued | $3.80 | $9.12 | $14.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $14.45 Median $34.67 Typical High $54.95 | Professional | 54 · Surgery only | $14.45 | $34.67 | $54.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.88 Median $6.92 Typical High $11.22 | Professional | 55 · Aftercare only | $2.88 | $6.92 | $11.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.91 Median $4.57 Typical High $7.41 | Professional | 56 · Pre-op care only | $1.91 | $4.57 | $7.41 |
Where Kentucky sits
The same service costs 3.4 times more in Wisconsin than in Kentucky. 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· 51st of 51
$36.31
WI $123KY $36.31
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.