How much rates vary
Facilitymedian $123 · 10th to 90th $60 to $1,380Professionalmedian $102 · 10th to 90th $62 to $158
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 $60.26 Median $114.82 Typical High $138.04 | Facility | None | $60.26 | $114.82 | $138.04 |
Aetna Setting Professional Modifier None Typical Low $60.26 Median $117.49 Typical High $165.96 | Professional | None | $60.26 | $117.49 | $165.96 |
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 $61.66 Median $100.00 Typical High $141.25 | Professional | None | $61.66 | $100.00 | $141.25 |
CareSource Setting Facility Modifier None Typical Low $64.57 Median $524.81 Typical High $933.25 | Facility | None | $64.57 | $524.81 | $933.25 |
CareSource Setting Professional Modifier None Typical Low $58.88 Median $89.13 Typical High $109.65 | Professional | None | $58.88 | $89.13 | $109.65 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $75.86 Typical High $102.33 | Facility | None | $34.67 | $75.86 | $102.33 |
Cigna Setting Professional Modifier None Typical Low $67.61 Median $138.04 Typical High $707.95 | Professional | None | $67.61 | $138.04 | $707.95 |
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 $109.65 Typical High $194.98 | Professional | None | $64.57 | $109.65 | $194.98 |
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 $30.20 Median $57.54 Typical High $69.18 | Facility | 52 · Reduced service | $30.20 | $57.54 | $69.18 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $12.02 Median $22.91 Typical High $27.54 | Facility | 53 · Discontinued | $12.02 | $22.91 | $27.54 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $45.71 Median $85.11 Typical High $104.71 | Facility | 54 · Surgery only | $45.71 | $85.11 | $104.71 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $9.12 Median $17.38 Typical High $20.89 | Facility | 55 · Aftercare only | $9.12 | $17.38 | $20.89 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $6.03 Median $11.48 Typical High $13.80 | Facility | 56 · Pre-op care only | $6.03 | $11.48 | $13.80 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $30.20 Median $57.54 Typical High $69.18 | Professional | 52 · Reduced service | $30.20 | $57.54 | $69.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $22.91 Typical High $27.54 | Professional | 53 · Discontinued | $12.02 | $22.91 | $27.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $45.71 Median $85.11 Typical High $104.71 | Professional | 54 · Surgery only | $45.71 | $85.11 | $104.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $17.38 Typical High $20.89 | Professional | 55 · Aftercare only | $9.12 | $17.38 | $20.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $11.48 Typical High $13.80 | Professional | 56 · Pre-op care only | $6.03 | $11.48 | $13.80 |
Where Kentucky sits
The same service costs 3.5 times more in Alaska than in Maryland. 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
$102
AK $355MD $100
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.