How much rates vary
Facilitymedian $115 · 10th to 90th $50 to $1,380Professionalmedian $85 · 10th to 90th $51 to $138
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 $100.00 Typical High $125.89 | Facility | None | $50.12 | $100.00 | $125.89 |
Aetna Setting Professional Modifier None Typical Low $50.12 Median $104.71 Typical High $154.88 | Professional | None | $50.12 | $104.71 | $154.88 |
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 $51.29 Median $83.18 Typical High $120.23 | Professional | None | $51.29 | $83.18 | $120.23 |
CareSource Setting Facility Modifier None Typical Low $53.70 Median $524.81 Typical High $933.25 | Facility | None | $53.70 | $524.81 | $933.25 |
CareSource Setting Professional Modifier None Typical Low $66.07 Median $120.23 Typical High $165.96 | Professional | None | $66.07 | $120.23 | $165.96 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $75.86 Typical High $87.10 | Facility | None | $34.67 | $75.86 | $87.10 |
Cigna Setting Professional Modifier None Typical Low $56.23 Median $117.49 Typical High $630.96 | Professional | None | $56.23 | $117.49 | $630.96 |
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 $54.95 Median $93.33 Typical High $165.96 | Professional | None | $54.95 | $93.33 | $165.96 |
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 $50.12 Typical High $61.66 | Facility | 52 · Reduced service | $25.12 | $50.12 | $61.66 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $10.23 Median $19.95 Typical High $25.12 | Facility | 53 · Discontinued | $10.23 | $19.95 | $25.12 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $38.02 Median $74.13 Typical High $93.33 | Facility | 54 · Surgery only | $38.02 | $74.13 | $93.33 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $7.59 Median $14.79 Typical High $18.62 | Facility | 55 · Aftercare only | $7.59 | $14.79 | $18.62 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $5.13 Median $10.00 Typical High $12.59 | Facility | 56 · Pre-op care only | $5.13 | $10.00 | $12.59 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $25.12 Median $50.12 Typical High $61.66 | Professional | 52 · Reduced service | $25.12 | $50.12 | $61.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.23 Median $19.95 Typical High $25.12 | Professional | 53 · Discontinued | $10.23 | $19.95 | $25.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $38.02 Median $74.13 Typical High $93.33 | Professional | 54 · Surgery only | $38.02 | $74.13 | $93.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.59 Median $14.79 Typical High $18.62 | Professional | 55 · Aftercare only | $7.59 | $14.79 | $18.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.13 Median $10.00 Typical High $12.59 | Professional | 56 · Pre-op care only | $5.13 | $10.00 | $12.59 |
Where Kentucky sits
The same service costs 3.5 times more in Alaska than in New Jersey. 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
$85.11
AK $302NJ $85.11
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.