How much rates vary
Facilitymedian $115 · 10th to 90th $47 to $1,862Professionalmedian $89 · 10th to 90th $54 to $145
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 $46.77 Median $77.62 Typical High $851.14 | Facility | None | $46.77 | $77.62 | $851.14 |
Aetna Setting Professional Modifier None Typical Low $46.77 Median $77.62 Typical High $109.65 | Professional | None | $46.77 | $77.62 | $109.65 |
Ambetter Setting Professional Modifier None Typical Low $134.90 Median $134.90 Typical High $134.90 | Professional | None | $134.90 | $134.90 | $134.90 |
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 $89.13 Typical High $144.54 | Professional | None | $64.57 | $89.13 | $144.54 |
CareSource Setting Facility Modifier None Typical Low $50.12 Median $524.81 Typical High $933.25 | Facility | None | $50.12 | $524.81 | $933.25 |
CareSource Setting Professional Modifier None Typical Low $45.71 Median $72.44 Typical High $85.11 | Professional | None | $45.71 | $72.44 | $85.11 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $75.86 Typical High $87.10 | Facility | None | $34.67 | $75.86 | $87.10 |
Cigna Setting Professional Modifier None Typical Low $52.48 Median $89.13 Typical High $616.60 | Professional | None | $52.48 | $89.13 | $616.60 |
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 $69.18 Median $93.33 Typical High $141.25 | Professional | None | $69.18 | $93.33 | $141.25 |
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 $23.44 Median $38.90 Typical High $58.88 | Facility | 52 · Reduced service | $23.44 | $38.90 | $58.88 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $9.33 Median $15.49 Typical High $23.44 | Facility | 53 · Discontinued | $9.33 | $15.49 | $23.44 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $35.48 Median $58.88 Typical High $89.13 | Facility | 54 · Surgery only | $35.48 | $58.88 | $89.13 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $7.08 Median $11.75 Typical High $17.78 | Facility | 55 · Aftercare only | $7.08 | $11.75 | $17.78 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $4.68 Median $7.76 Typical High $11.75 | Facility | 56 · Pre-op care only | $4.68 | $7.76 | $11.75 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $23.44 Median $38.02 Typical High $43.65 | Professional | 52 · Reduced service | $23.44 | $38.02 | $43.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.33 Median $15.49 Typical High $17.78 | Professional | 53 · Discontinued | $9.33 | $15.49 | $17.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $35.48 Median $57.54 Typical High $66.07 | Professional | 54 · Surgery only | $35.48 | $57.54 | $66.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.08 Median $11.48 Typical High $13.18 | Professional | 55 · Aftercare only | $7.08 | $11.48 | $13.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.68 Median $7.59 Typical High $8.91 | Professional | 56 · Pre-op care only | $4.68 | $7.59 | $8.91 |
Where Kentucky sits
The same service costs 3.2 times more in Alaska than in New York. 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· 43rd of 51
$89.13
AK $245NY $77.62
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.