How much rates vary
Facilitymedian $112 · 10th to 90th $52 to $1,380Professionalmedian $87 · 10th to 90th $55 to $141
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 $52.48 Median $100.00 Typical High $125.89 | Facility | None | $52.48 | $100.00 | $125.89 |
Aetna Setting Professional Modifier None Typical Low $52.48 Median $102.33 Typical High $147.91 | Professional | None | $52.48 | $102.33 | $147.91 |
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 $54.95 Median $75.86 Typical High $123.03 | Professional | None | $54.95 | $75.86 | $123.03 |
CareSource Setting Facility Modifier None Typical Low $56.23 Median $91.20 Typical High $151.36 | Facility | None | $56.23 | $91.20 | $151.36 |
CareSource Setting Professional Modifier None Typical Low $51.29 Median $79.43 Typical High $93.33 | Professional | None | $51.29 | $79.43 | $93.33 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $93.33 Typical High $107.15 | Facility | None | $34.67 | $93.33 | $107.15 |
Cigna Setting Professional Modifier None Typical Low $58.88 Median $123.03 Typical High $630.96 | Professional | None | $58.88 | $123.03 | $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 $57.54 Median $95.50 Typical High $169.82 | Professional | None | $57.54 | $95.50 | $169.82 |
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 $26.30 Median $50.12 Typical High $63.10 | Facility | 52 · Reduced service | $26.30 | $50.12 | $63.10 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $10.47 Median $20.42 Typical High $25.12 | Facility | 53 · Discontinued | $10.47 | $20.42 | $25.12 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $39.81 Median $75.86 Typical High $93.33 | Facility | 54 · Surgery only | $39.81 | $75.86 | $93.33 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $7.94 Median $15.14 Typical High $18.62 | Facility | 55 · Aftercare only | $7.94 | $15.14 | $18.62 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $5.25 Median $10.00 Typical High $12.59 | Facility | 56 · Pre-op care only | $5.25 | $10.00 | $12.59 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $26.30 Median $50.12 Typical High $63.10 | Professional | 52 · Reduced service | $26.30 | $50.12 | $63.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.47 Median $20.42 Typical High $25.12 | Professional | 53 · Discontinued | $10.47 | $20.42 | $25.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $39.81 Median $75.86 Typical High $93.33 | Professional | 54 · Surgery only | $39.81 | $75.86 | $93.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.94 Median $15.14 Typical High $18.62 | Professional | 55 · Aftercare only | $7.94 | $15.14 | $18.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.25 Median $10.00 Typical High $12.59 | Professional | 56 · Pre-op care only | $5.25 | $10.00 | $12.59 |
Where Kentucky sits
The same service costs 3.1 times more in Alaska 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
$87.10
AK $269KY $87.10
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.