How much rates vary
Facilitymedian $126 · 10th to 90th $63 to $1,148Professionalmedian $95 · 10th to 90th $63 to $151
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 $63.10 Median $112.20 Typical High $269.15 | Facility | None | $63.10 | $112.20 | $269.15 |
Aetna Setting Professional Modifier None Typical Low $63.10 Median $120.23 Typical High $165.96 | Professional | None | $63.10 | $120.23 | $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 $64.57 Median $95.50 Typical High $134.90 | Professional | None | $64.57 | $95.50 | $134.90 |
CareSource Setting Facility Modifier None Typical Low $67.61 Median $109.65 Typical High $173.78 | Facility | None | $67.61 | $109.65 | $173.78 |
CareSource Setting Professional Modifier None Typical Low $63.10 Median $95.50 Typical High $112.20 | Professional | None | $63.10 | $95.50 | $112.20 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $107.15 Typical High $125.89 | Facility | None | $34.67 | $107.15 | $125.89 |
Cigna Setting Professional Modifier None Typical Low $69.18 Median $134.90 Typical High $724.44 | Professional | None | $69.18 | $134.90 | $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 $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 $104.71 Typical High $186.21 | Professional | None | $64.57 | $104.71 | $186.21 |
11 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 $31.62 Median $54.95 Typical High $70.79 | Facility | 52 · Reduced service | $31.62 | $54.95 | $70.79 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $12.59 Median $22.39 Typical High $28.18 | Facility | 53 · Discontinued | $12.59 | $22.39 | $28.18 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $47.86 Median $83.18 Typical High $107.15 | Facility | 54 · Surgery only | $47.86 | $83.18 | $107.15 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $9.55 Median $16.60 Typical High $21.38 | Facility | 55 · Aftercare only | $9.55 | $16.60 | $21.38 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $6.31 Median $11.22 Typical High $14.13 | Facility | 56 · Pre-op care only | $6.31 | $11.22 | $14.13 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $31.62 Median $54.95 Typical High $70.79 | Professional | 52 · Reduced service | $31.62 | $54.95 | $70.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.59 Median $22.39 Typical High $28.18 | Professional | 53 · Discontinued | $12.59 | $22.39 | $28.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $47.86 Median $83.18 Typical High $107.15 | Professional | 54 · Surgery only | $47.86 | $83.18 | $107.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.55 Median $16.60 Typical High $21.38 | Professional | 55 · Aftercare only | $9.55 | $16.60 | $21.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.31 Median $11.22 Typical High $14.13 | Professional | 56 · Pre-op care only | $6.31 | $11.22 | $14.13 |
Ambetter Setting Professional Modifier 51 · Multiple procedures Typical Low $165.96 Median $165.96 Typical High $165.96 | Professional | 51 · Multiple procedures | $165.96 | $165.96 | $165.96 |
Where Kentucky sits
The same service costs 3.2 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
$97.72
AK $309KY $97.72
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.