How much rates vary
Facilitymedian $132 · 10th to 90th $65 to $3,311Professionalmedian $132 · 10th to 90th $69 to $437
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 $64.57 Median $131.83 Typical High $851.14 | Facility | None | $64.57 | $131.83 | $851.14 |
Aetna Setting Professional Modifier None Typical Low $64.57 Median $131.83 Typical High $186.21 | Professional | None | $64.57 | $131.83 | $186.21 |
Anthem BCBS Setting Facility Modifier None Typical Low $9,120.11 Median $10,715.19 Typical High $11,220.18 | Facility | None | $9,120.11 | $10,715.19 | $11,220.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $69.18 Median $125.89 Typical High $436.52 | Professional | None | $69.18 | $125.89 | $436.52 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $104.71 Median $190.55 Typical High $676.08 | Professional | 50 · Both sides | $104.71 | $190.55 | $676.08 |
CareSource Setting Facility Modifier None Typical Low $58.88 Median $70.79 Typical High $112.20 | Facility | None | $58.88 | $70.79 | $112.20 |
CareSource Setting Professional Modifier None Typical Low $75.86 Median $97.72 Typical High $114.82 | Professional | None | $75.86 | $97.72 | $114.82 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $114.82 Typical High $114.82 | Facility | None | $34.67 | $114.82 | $114.82 |
Cigna Setting Professional Modifier None Typical Low $70.79 Median $158.49 Typical High $1,202.26 | Professional | None | $70.79 | $158.49 | $1,202.26 |
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 $50.12 Median $416.87 Typical High $1,949.84 | Facility | None | $50.12 | $416.87 | $1,949.84 |
United Setting Professional Modifier None Typical Low $74.13 Median $141.25 Typical High $239.88 | Professional | None | $74.13 | $141.25 | $239.88 |
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 $32.36 Median $66.07 Typical High $112.20 | Facility | 52 · Reduced service | $32.36 | $66.07 | $112.20 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $12.88 Median $26.30 Typical High $44.67 | Facility | 53 · Discontinued | $12.88 | $26.30 | $44.67 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $47.86 Median $100.00 Typical High $165.96 | Facility | 54 · Surgery only | $47.86 | $100.00 | $165.96 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $9.55 Median $19.95 Typical High $33.88 | Facility | 55 · Aftercare only | $9.55 | $19.95 | $33.88 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $6.46 Median $13.18 Typical High $22.39 | Facility | 56 · Pre-op care only | $6.46 | $13.18 | $22.39 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $32.36 Median $66.07 Typical High $81.28 | Professional | 52 · Reduced service | $32.36 | $66.07 | $81.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.88 Median $26.30 Typical High $33.11 | Professional | 53 · Discontinued | $12.88 | $26.30 | $33.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $47.86 Median $97.72 Typical High $123.03 | Professional | 54 · Surgery only | $47.86 | $97.72 | $123.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.55 Median $19.50 Typical High $24.55 | Professional | 55 · Aftercare only | $9.55 | $19.50 | $24.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.46 Median $13.18 Typical High $16.22 | Professional | 56 · Pre-op care only | $6.46 | $13.18 | $16.22 |
Where Kentucky sits
The same service costs 2.6 times more in Wisconsin than in Utah. 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· 45th of 51
$132
WI $309UT $120
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.