How much rates vary
Facilitymedian $813 · 10th to 90th $87 to $2,818Professionalmedian $302 · 10th to 90th $71 to $589
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 $70.79 Median $281.84 Typical High $616.60 | Facility | None | $70.79 | $281.84 | $616.60 |
Aetna Setting Professional Modifier None Typical Low $70.79 Median $275.42 Typical High $436.52 | Professional | None | $70.79 | $275.42 | $436.52 |
Ambetter Setting Professional Modifier None Typical Low $95.50 Median $95.50 Typical High $138.04 | Professional | None | $95.50 | $95.50 | $138.04 |
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 $67.61 Median $302.00 Typical High $489.78 | Professional | None | $67.61 | $302.00 | $489.78 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $102.33 Median $446.68 Typical High $707.95 | Professional | 50 · Both sides | $102.33 | $446.68 | $707.95 |
CareSource Setting Facility Modifier None Typical Low $75.86 Median $524.81 Typical High $933.25 | Facility | None | $75.86 | $524.81 | $933.25 |
CareSource Setting Professional Modifier None Typical Low $97.72 Median $309.03 Typical High $436.52 | Professional | None | $97.72 | $309.03 | $436.52 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $128.82 Typical High $1,122.02 | Facility | None | $34.67 | $128.82 | $1,122.02 |
Cigna Setting Professional Modifier None Typical Low $79.43 Median $323.59 Typical High $1,905.46 | Professional | None | $79.43 | $323.59 | $1,905.46 |
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 $323.59 Median $588.84 Typical High $1,995.26 | Facility | None | $323.59 | $588.84 | $1,995.26 |
United Setting Professional Modifier None Typical Low $77.62 Median $323.59 Typical High $676.08 | Professional | None | $77.62 | $323.59 | $676.08 |
9 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 $35.48 Median $44.67 Typical High $218.78 | Facility | 52 · Reduced service | $35.48 | $44.67 | $218.78 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $14.13 Median $17.78 Typical High $87.10 | Facility | 53 · Discontinued | $14.13 | $17.78 | $87.10 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $53.70 Median $67.61 Typical High $331.13 | Facility | 54 · Surgery only | $53.70 | $67.61 | $331.13 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $10.72 Median $13.49 Typical High $66.07 | Facility | 55 · Aftercare only | $10.72 | $13.49 | $66.07 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $35.48 Median $58.88 Typical High $158.49 | Professional | 52 · Reduced service | $35.48 | $58.88 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.13 Median $23.44 Typical High $64.57 | Professional | 53 · Discontinued | $14.13 | $23.44 | $64.57 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $53.70 Median $89.13 Typical High $239.88 | Professional | 54 · Surgery only | $53.70 | $89.13 | $239.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.72 Median $17.78 Typical High $47.86 | Professional | 55 · Aftercare only | $10.72 | $17.78 | $47.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.08 Median $11.75 Typical High $32.36 | Professional | 56 · Pre-op care only | $7.08 | $11.75 | $32.36 |
Where Kentucky sits
The same service costs 5.5 times more in Connecticut than in Montana. 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 $3,114MT $570
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.