How much rates vary
Facilitymedian $100 · 10th to 90th $41 to $1,148Professionalmedian $66 · 10th to 90th $37 to $117
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 $38.02 Median $81.28 Typical High $141.25 | Facility | None | $38.02 | $81.28 | $141.25 |
Aetna Setting Professional Modifier None Typical Low $38.02 Median $81.28 Typical High $131.83 | Professional | None | $38.02 | $81.28 | $131.83 |
Ambetter Setting Professional Modifier None Typical Low $97.72 Median $102.33 Typical High $102.33 | Professional | None | $97.72 | $102.33 | $102.33 |
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 $36.31 Median $58.88 Typical High $95.50 | Professional | None | $36.31 | $58.88 | $95.50 |
CareSource Setting Facility Modifier None Typical Low $40.74 Median $57.54 Typical High $138.04 | Facility | None | $40.74 | $57.54 | $138.04 |
CareSource Setting Professional Modifier None Typical Low $50.12 Median $100.00 Typical High $138.04 | Professional | None | $50.12 | $100.00 | $138.04 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $75.86 Typical High $100.00 | Facility | None | $34.67 | $75.86 | $100.00 |
Cigna Setting Professional Modifier None Typical Low $42.66 Median $93.33 Typical High $537.03 | Professional | None | $42.66 | $93.33 | $537.03 |
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 $38.90 Median $70.79 Typical High $131.83 | Professional | None | $38.90 | $70.79 | $131.83 |
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 $19.05 Median $40.74 Typical High $52.48 | Facility | 52 · Reduced service | $19.05 | $40.74 | $52.48 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $7.59 Median $16.22 Typical High $20.89 | Facility | 53 · Discontinued | $7.59 | $16.22 | $20.89 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $28.84 Median $61.66 Typical High $77.62 | Facility | 54 · Surgery only | $28.84 | $61.66 | $77.62 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $5.75 Median $12.30 Typical High $15.49 | Facility | 55 · Aftercare only | $5.75 | $12.30 | $15.49 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $3.80 Median $8.13 Typical High $10.47 | Facility | 56 · Pre-op care only | $3.80 | $8.13 | $10.47 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $19.05 Median $40.74 Typical High $52.48 | Professional | 52 · Reduced service | $19.05 | $40.74 | $52.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.59 Median $16.22 Typical High $20.89 | Professional | 53 · Discontinued | $7.59 | $16.22 | $20.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $28.84 Median $61.66 Typical High $77.62 | Professional | 54 · Surgery only | $28.84 | $61.66 | $77.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.75 Median $12.30 Typical High $15.49 | Professional | 55 · Aftercare only | $5.75 | $12.30 | $15.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.80 Median $8.13 Typical High $10.47 | Professional | 56 · Pre-op care only | $3.80 | $8.13 | $10.47 |
Where Kentucky sits
The same service costs 3.5 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
$66.07
AK $229KY $66.07
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.