How much rates vary
Facilitymedian $110 · 10th to 90th $28 to $1,778Professionalmedian $42 · 10th to 90th $26 to $65
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 $25.12 Median $46.77 Typical High $851.14 | Facility | None | $25.12 | $46.77 | $851.14 |
Aetna Setting Professional Modifier None Typical Low $25.12 Median $46.77 Typical High $72.44 | Professional | None | $25.12 | $46.77 | $72.44 |
Ambetter Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $50.12 | Professional | None | $44.67 | $44.67 | $50.12 |
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 $25.70 Median $39.81 Typical High $61.66 | Professional | None | $25.70 | $39.81 | $61.66 |
CareSource Setting Facility Modifier None Typical Low $26.92 Median $524.81 Typical High $933.25 | Facility | None | $26.92 | $524.81 | $933.25 |
CareSource Setting Professional Modifier None Typical Low $32.36 Median $51.29 Typical High $70.79 | Professional | None | $32.36 | $51.29 | $70.79 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $42.66 Typical High $75.86 | Facility | None | $34.67 | $42.66 | $75.86 |
Cigna Setting Professional Modifier None Typical Low $28.18 Median $52.48 Typical High $295.12 | Professional | None | $28.18 | $52.48 | $295.12 |
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 $26.92 Median $46.77 Typical High $74.13 | Professional | None | $26.92 | $46.77 | $74.13 |
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 $12.59 Median $23.44 Typical High $28.18 | Facility | 52 · Reduced service | $12.59 | $23.44 | $28.18 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $5.01 Median $9.33 Typical High $11.22 | Facility | 53 · Discontinued | $5.01 | $9.33 | $11.22 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $18.62 Median $35.48 Typical High $41.69 | Facility | 54 · Surgery only | $18.62 | $35.48 | $41.69 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $3.72 Median $7.08 Typical High $8.32 | Facility | 55 · Aftercare only | $3.72 | $7.08 | $8.32 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $2.51 Median $4.68 Typical High $5.62 | Facility | 56 · Pre-op care only | $2.51 | $4.68 | $5.62 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $12.59 Median $21.38 Typical High $26.30 | Professional | 52 · Reduced service | $12.59 | $21.38 | $26.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.01 Median $8.51 Typical High $10.47 | Professional | 53 · Discontinued | $5.01 | $8.51 | $10.47 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $18.62 Median $32.36 Typical High $39.81 | Professional | 54 · Surgery only | $18.62 | $32.36 | $39.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.72 Median $6.46 Typical High $7.94 | Professional | 55 · Aftercare only | $3.72 | $6.46 | $7.94 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.51 Median $4.27 Typical High $5.25 | Professional | 56 · Pre-op care only | $2.51 | $4.27 | $5.25 |
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
$42.66
AK $151KY $42.66
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.