How much rates vary
Facilitymedian $891 · 10th to 90th $100 to $4,169Professionalmedian $126 · 10th to 90th $81 to $209
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 $79.43 Median $131.83 Typical High $537.03 | Facility | None | $79.43 | $131.83 | $537.03 |
Aetna Setting Professional Modifier None Typical Low $79.43 Median $131.83 Typical High $194.98 | Professional | None | $79.43 | $131.83 | $194.98 |
Anthem BCBS Setting Facility Modifier None Typical Low $724.44 Median $1,995.26 Typical High $4,466.84 | Facility | None | $724.44 | $1,995.26 | $4,466.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $79.43 Median $109.65 Typical High $151.36 | Professional | None | $79.43 | $109.65 | $151.36 |
CareSource Setting Facility Modifier None Typical Low $85.11 Median $117.49 Typical High $151.36 | Facility | None | $85.11 | $117.49 | $151.36 |
CareSource Setting Professional Modifier None Typical Low $104.71 Median $141.25 Typical High $199.53 | Professional | None | $104.71 | $141.25 | $199.53 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $109.65 Typical High $398.11 | Facility | None | $34.67 | $109.65 | $398.11 |
Cigna Setting Professional Modifier None Typical Low $89.13 Median $147.91 Typical High $776.25 | Professional | None | $89.13 | $147.91 | $776.25 |
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 $457.09 Median $794.33 Typical High $2,454.71 | Facility | None | $457.09 | $794.33 | $2,454.71 |
United Setting Professional Modifier None Typical Low $95.50 Median $144.54 Typical High $234.42 | Professional | None | $95.50 | $144.54 | $234.42 |
11 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 $39.81 Median $50.12 Typical High $74.13 | Facility | 52 · Reduced service | $39.81 | $50.12 | $74.13 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $15.85 Median $19.95 Typical High $29.51 | Facility | 53 · Discontinued | $15.85 | $19.95 | $29.51 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $60.26 Median $75.86 Typical High $112.20 | Facility | 54 · Surgery only | $60.26 | $75.86 | $112.20 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $12.02 Median $15.14 Typical High $22.39 | Facility | 55 · Aftercare only | $12.02 | $15.14 | $22.39 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $7.94 Median $10.00 Typical High $14.79 | Facility | 56 · Pre-op care only | $7.94 | $10.00 | $14.79 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $39.81 Median $57.54 Typical High $74.13 | Professional | 52 · Reduced service | $39.81 | $57.54 | $74.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.85 Median $22.91 Typical High $29.51 | Professional | 53 · Discontinued | $15.85 | $22.91 | $29.51 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $60.26 Median $85.11 Typical High $112.20 | Professional | 54 · Surgery only | $60.26 | $85.11 | $112.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $16.98 Typical High $22.39 | Professional | 55 · Aftercare only | $12.02 | $16.98 | $22.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $11.48 Typical High $14.79 | Professional | 56 · Pre-op care only | $7.94 | $11.48 | $14.79 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $97.72 Median $97.72 Typical High $97.72 | Professional | 59 · Distinct service | $97.72 | $97.72 | $97.72 |
Where Kentucky sits
The same service costs 3.2 times more in Alaska than in New Jersey. 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
$135
AK $407NJ $129
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.