How much rates vary
Facilitymedian $158 · 10th to 90th $81 to $1,778Professionalmedian $166 · 10th to 90th $91 to $324
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 $154.88 Typical High $794.33 | Facility | None | $81.28 | $154.88 | $794.33 |
Aetna Setting Professional Modifier None Typical Low $81.28 Median $144.54 Typical High $234.42 | Professional | None | $81.28 | $144.54 | $234.42 |
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 $91.20 Median $169.82 Typical High $323.59 | Professional | None | $91.20 | $169.82 | $323.59 |
CareSource Setting Facility Modifier None Typical Low $83.18 Median $138.04 Typical High $181.97 | Facility | None | $83.18 | $138.04 | $181.97 |
CareSource Setting Professional Modifier None Typical Low $85.11 Median $123.03 Typical High $144.54 | Professional | None | $85.11 | $123.03 | $144.54 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $125.89 Typical High $162.18 | Facility | None | $34.67 | $125.89 | $162.18 |
Cigna Setting Professional Modifier None Typical Low $91.20 Median $181.97 Typical High $1,548.82 | Professional | None | $91.20 | $181.97 | $1,548.82 |
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 $100.00 Median $173.78 Typical High $295.12 | Professional | None | $100.00 | $173.78 | $295.12 |
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 $70.79 Typical High $147.91 | Facility | 52 · Reduced service | $40.74 | $70.79 | $147.91 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $16.22 Median $28.84 Typical High $58.88 | Facility | 53 · Discontinued | $16.22 | $28.84 | $58.88 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $60.26 Median $107.15 Typical High $218.78 | Facility | 54 · Surgery only | $60.26 | $107.15 | $218.78 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $12.02 Median $21.38 Typical High $43.65 | Facility | 55 · Aftercare only | $12.02 | $21.38 | $43.65 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $8.13 Median $14.45 Typical High $29.51 | Facility | 56 · Pre-op care only | $8.13 | $14.45 | $29.51 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $40.74 Median $64.57 Typical High $81.28 | Professional | 52 · Reduced service | $40.74 | $64.57 | $81.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.22 Median $26.30 Typical High $32.36 | Professional | 53 · Discontinued | $16.22 | $26.30 | $32.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $60.26 Median $97.72 Typical High $120.23 | Professional | 54 · Surgery only | $60.26 | $97.72 | $120.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $19.50 Typical High $24.55 | Professional | 55 · Aftercare only | $12.02 | $19.50 | $24.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.13 Median $12.88 Typical High $16.22 | Professional | 56 · Pre-op care only | $8.13 | $12.88 | $16.22 |
Where Kentucky sits
The same service costs 11.6 times more in Hawaii 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
HI $3,027MD $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.