How much rates vary
Facilitymedian $1,122 · 10th to 90th $110 to $2,818Professionalmedian $117 · 10th to 90th $59 to $355
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 $58.88 Median $120.23 Typical High $851.14 | Facility | None | $58.88 | $120.23 | $851.14 |
Aetna Setting Professional Modifier None Typical Low $58.88 Median $117.49 Typical High $134.90 | Professional | None | $58.88 | $117.49 | $134.90 |
Anthem BCBS Setting Facility Modifier None Typical Low $602.56 Median $1,698.24 Typical High $2,884.03 | Facility | None | $602.56 | $1,698.24 | $2,884.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $57.54 Median $117.49 Typical High $354.81 | Professional | None | $57.54 | $117.49 | $354.81 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $87.10 Median $173.78 Typical High $537.03 | Professional | 50 · Both sides | $87.10 | $173.78 | $537.03 |
CareSource Setting Facility Modifier None Typical Low $60.26 Median $102.33 Typical High $1,202.26 | Facility | None | $60.26 | $102.33 | $1,202.26 |
CareSource Setting Professional Modifier None Typical Low $69.18 Median $89.13 Typical High $104.71 | Professional | None | $69.18 | $89.13 | $104.71 |
Cigna Setting Facility Modifier None Typical Low $109.65 Median $851.14 Typical High $1,318.26 | Facility | None | $109.65 | $851.14 | $1,318.26 |
Cigna Setting Professional Modifier None Typical Low $66.07 Median $134.90 Typical High $794.33 | Professional | None | $66.07 | $134.90 | $794.33 |
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 $58.88 Median $120.23 Typical High $218.78 | Professional | None | $58.88 | $120.23 | $218.78 |
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 $29.51 Median $60.26 Typical High $67.61 | Facility | 52 · Reduced service | $29.51 | $60.26 | $67.61 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $11.75 Median $23.99 Typical High $26.92 | Facility | 53 · Discontinued | $11.75 | $23.99 | $26.92 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $43.65 Median $89.13 Typical High $100.00 | Facility | 54 · Surgery only | $43.65 | $89.13 | $100.00 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $8.71 Median $17.78 Typical High $20.42 | Facility | 55 · Aftercare only | $8.71 | $17.78 | $20.42 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $5.89 Median $12.02 Typical High $13.49 | Facility | 56 · Pre-op care only | $5.89 | $12.02 | $13.49 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $29.51 Median $58.88 Typical High $67.61 | Professional | 52 · Reduced service | $29.51 | $58.88 | $67.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.75 Median $23.44 Typical High $26.92 | Professional | 53 · Discontinued | $11.75 | $23.44 | $26.92 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $43.65 Median $89.13 Typical High $100.00 | Professional | 54 · Surgery only | $43.65 | $89.13 | $100.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.71 Median $17.78 Typical High $20.42 | Professional | 55 · Aftercare only | $8.71 | $17.78 | $20.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.89 Median $11.75 Typical High $13.49 | Professional | 56 · Pre-op care only | $5.89 | $11.75 | $13.49 |
Where Kentucky sits
The same service costs 4.9 times more in Alaska than in Hawaii. 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
$126
AK $437HI $89.13
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.