How much rates vary
Facilitymedian $851 · 10th to 90th $56 to $2,818Professionalmedian $95 · 10th to 90th $48 to $186
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 $47.86 Median $123.03 Typical High $794.33 | Facility | None | $47.86 | $123.03 | $794.33 |
Aetna Setting Professional Modifier None Typical Low $47.86 Median $123.03 Typical High $173.78 | Professional | None | $47.86 | $123.03 | $173.78 |
Ambetter Setting Professional Modifier None Typical Low $56.23 Median $56.23 Typical High $138.04 | Professional | None | $56.23 | $56.23 | $138.04 |
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 $40.74 Median $95.50 Typical High $141.25 | Professional | None | $40.74 | $95.50 | $141.25 |
CareSource Setting Facility Modifier None Typical Low $44.67 Median $83.18 Typical High $186.21 | Facility | None | $44.67 | $83.18 | $186.21 |
CareSource Setting Professional Modifier None Typical Low $47.86 Median $72.44 Typical High $85.11 | Professional | None | $47.86 | $72.44 | $85.11 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $125.89 Typical High $691.83 | Facility | None | $34.67 | $125.89 | $691.83 |
Cigna Setting Professional Modifier None Typical Low $53.70 Median $141.25 Typical High $724.44 | Professional | None | $53.70 | $141.25 | $724.44 |
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 $323.59 Median $588.84 Typical High $1,621.81 | Facility | None | $323.59 | $588.84 | $1,621.81 |
United Setting Professional Modifier None Typical Low $56.23 Median $123.03 Typical High $208.93 | Professional | None | $56.23 | $123.03 | $208.93 |
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 $23.99 Median $28.18 Typical High $69.18 | Facility | 52 · Reduced service | $23.99 | $28.18 | $69.18 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $9.55 Median $11.22 Typical High $28.18 | Facility | 53 · Discontinued | $9.55 | $11.22 | $28.18 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $36.31 Median $42.66 Typical High $104.71 | Facility | 54 · Surgery only | $36.31 | $42.66 | $104.71 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $7.24 Median $8.51 Typical High $20.89 | Facility | 55 · Aftercare only | $7.24 | $8.51 | $20.89 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $4.79 Median $5.62 Typical High $14.13 | Facility | 56 · Pre-op care only | $4.79 | $5.62 | $14.13 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $23.99 Median $39.81 Typical High $69.18 | Professional | 52 · Reduced service | $23.99 | $39.81 | $69.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.55 Median $15.85 Typical High $28.18 | Professional | 53 · Discontinued | $9.55 | $15.85 | $28.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $36.31 Median $60.26 Typical High $104.71 | Professional | 54 · Surgery only | $36.31 | $60.26 | $104.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.24 Median $12.02 Typical High $20.89 | Professional | 55 · Aftercare only | $7.24 | $12.02 | $20.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.79 Median $7.94 Typical High $14.13 | Professional | 56 · Pre-op care only | $4.79 | $7.94 | $14.13 |
Where Kentucky sits
The same service costs 2.6 times more in Alaska than in Montana. 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· 49th of 51
$112
AK $282MT $107
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.