How much rates vary
Facilitymedian $145 · 10th to 90th $78 to $1,380Professionalmedian $120 · 10th to 90th $81 to $182
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 $81.28 Median $144.54 Typical High $165.96 | Facility | None | $81.28 | $144.54 | $165.96 |
Aetna Setting Professional Modifier None Typical Low $81.28 Median $144.54 Typical High $190.55 | Professional | None | $81.28 | $144.54 | $190.55 |
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 $81.28 Median $120.23 Typical High $173.78 | Professional | None | $81.28 | $120.23 | $173.78 |
CareSource Setting Facility Modifier None Typical Low $87.10 Median $141.25 Typical High $190.55 | Facility | None | $87.10 | $141.25 | $190.55 |
CareSource Setting Professional Modifier None Typical Low $79.43 Median $117.49 Typical High $144.54 | Professional | None | $79.43 | $117.49 | $144.54 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $134.90 Typical High $141.25 | Facility | None | $34.67 | $134.90 | $141.25 |
Cigna Setting Professional Modifier None Typical Low $91.20 Median $165.96 Typical High $851.14 | Professional | None | $91.20 | $165.96 | $851.14 |
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 $87.10 Median $128.82 Typical High $229.09 | Professional | None | $87.10 | $128.82 | $229.09 |
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 $40.74 Median $72.44 Typical High $83.18 | Facility | 52 · Reduced service | $40.74 | $72.44 | $83.18 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $16.22 Median $28.84 Typical High $33.11 | Facility | 53 · Discontinued | $16.22 | $28.84 | $33.11 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $60.26 Median $107.15 Typical High $125.89 | Facility | 54 · Surgery only | $60.26 | $107.15 | $125.89 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $12.02 Median $21.38 Typical High $25.12 | Facility | 55 · Aftercare only | $12.02 | $21.38 | $25.12 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $8.13 Median $14.45 Typical High $16.60 | Facility | 56 · Pre-op care only | $8.13 | $14.45 | $16.60 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $40.74 Median $70.79 Typical High $83.18 | Professional | 52 · Reduced service | $40.74 | $70.79 | $83.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.22 Median $28.84 Typical High $33.11 | Professional | 53 · Discontinued | $16.22 | $28.84 | $33.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $60.26 Median $107.15 Typical High $125.89 | Professional | 54 · Surgery only | $60.26 | $107.15 | $125.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $21.38 Typical High $25.12 | Professional | 55 · Aftercare only | $12.02 | $21.38 | $25.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.13 Median $14.45 Typical High $16.60 | Professional | 56 · Pre-op care only | $8.13 | $14.45 | $16.60 |
Where Kentucky sits
The same service costs 3.3 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· 50th of 51
$120
AK $398MD $120
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.