How much rates vary
Facilitymedian $813 · 10th to 90th $100 to $2,818Professionalmedian $195 · 10th to 90th $117 to $316
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 $89.13 Median $134.90 Typical High $851.14 | Facility | None | $89.13 | $134.90 | $851.14 |
Aetna Setting Professional Modifier None Typical Low $89.13 Median $128.82 Typical High $257.04 | Professional | None | $89.13 | $128.82 | $257.04 |
Ambetter Setting Professional Modifier None Typical Low $97.72 Median $134.90 Typical High $134.90 | Professional | None | $97.72 | $134.90 | $134.90 |
Anthem BCBS Setting Facility Modifier None Typical Low $588.84 Median $1,698.24 Typical High $2,884.03 | Facility | None | $588.84 | $1,698.24 | $2,884.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $147.91 Median $199.53 Typical High $316.23 | Professional | None | $147.91 | $199.53 | $316.23 |
CareSource Setting Facility Modifier None Typical Low $93.33 Median $524.81 Typical High $933.25 | Facility | None | $93.33 | $524.81 | $933.25 |
CareSource Setting Professional Modifier None Typical Low $114.82 Median $134.90 Typical High $181.97 | Professional | None | $114.82 | $134.90 | $181.97 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $75.86 Typical High $158.49 | Facility | None | $34.67 | $75.86 | $158.49 |
Cigna Setting Professional Modifier None Typical Low $97.72 Median $181.97 Typical High $1,348.96 | Professional | None | $97.72 | $181.97 | $1,348.96 |
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 $125.89 Median $199.53 Typical High $288.40 | Professional | None | $125.89 | $199.53 | $288.40 |
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 $43.65 Median $58.88 Typical High $128.82 | Facility | 52 · Reduced service | $43.65 | $58.88 | $128.82 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $17.78 Median $23.44 Typical High $51.29 | Facility | 53 · Discontinued | $17.78 | $23.44 | $51.29 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $66.07 Median $89.13 Typical High $194.98 | Facility | 54 · Surgery only | $66.07 | $89.13 | $194.98 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $13.18 Median $17.78 Typical High $38.90 | Facility | 55 · Aftercare only | $13.18 | $17.78 | $38.90 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $8.91 Median $11.75 Typical High $25.70 | Facility | 56 · Pre-op care only | $8.91 | $11.75 | $25.70 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $43.65 Median $58.88 Typical High $72.44 | Professional | 52 · Reduced service | $43.65 | $58.88 | $72.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.78 Median $23.44 Typical High $28.84 | Professional | 53 · Discontinued | $17.78 | $23.44 | $28.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $66.07 Median $89.13 Typical High $109.65 | Professional | 54 · Surgery only | $66.07 | $89.13 | $109.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $17.78 Typical High $21.88 | Professional | 55 · Aftercare only | $13.18 | $17.78 | $21.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.91 Median $11.75 Typical High $14.45 | Professional | 56 · Pre-op care only | $8.91 | $11.75 | $14.45 |
Where Kentucky sits
The same service costs 11.5 times more in Connecticut 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.
Physician feeFacility fee
CT $2,992MD $261
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.