How much rates vary
Facilitymedian $832 · 10th to 90th $129 to $5,623Professionalmedian $195 · 10th to 90th $120 to $347
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 $120.23 Median $218.78 Typical High $794.33 | Facility | None | $120.23 | $218.78 | $794.33 |
Aetna Setting Professional Modifier None Typical Low $120.23 Median $218.78 Typical High $245.47 | Professional | None | $120.23 | $218.78 | $245.47 |
Anthem BCBS Setting Facility Modifier None Typical Low $758.58 Median $7,244.36 Typical High $11,220.18 | Facility | None | $758.58 | $7,244.36 | $11,220.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $117.49 Median $194.98 Typical High $346.74 | Professional | None | $117.49 | $194.98 | $346.74 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $173.78 Median $295.12 Typical High $524.81 | Professional | 50 · Both sides | $173.78 | $295.12 | $524.81 |
CareSource Setting Facility Modifier None Typical Low $128.82 Median $208.93 Typical High $2,570.40 | Facility | None | $128.82 | $208.93 | $2,570.40 |
CareSource Setting Professional Modifier None Typical Low $144.54 Median $181.97 Typical High $218.78 | Professional | None | $144.54 | $181.97 | $218.78 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $281.84 Typical High $1,905.46 | Facility | None | $34.67 | $281.84 | $1,905.46 |
Cigna Setting Professional Modifier None Typical Low $134.90 Median $245.47 Typical High $2,137.96 | Professional | None | $134.90 | $245.47 | $2,137.96 |
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 $741.31 Median $1,479.11 Typical High $5,128.61 | Facility | None | $741.31 | $1,479.11 | $5,128.61 |
United Setting Professional Modifier None Typical Low $117.49 Median $204.17 Typical High $407.38 | Professional | None | $117.49 | $204.17 | $407.38 |
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 $60.26 Median $109.65 Typical High $199.53 | Facility | 52 · Reduced service | $60.26 | $109.65 | $199.53 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $23.99 Median $43.65 Typical High $79.43 | Facility | 53 · Discontinued | $23.99 | $43.65 | $79.43 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $91.20 Median $165.96 Typical High $295.12 | Facility | 54 · Surgery only | $91.20 | $165.96 | $295.12 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $18.20 Median $33.11 Typical High $58.88 | Facility | 55 · Aftercare only | $18.20 | $33.11 | $58.88 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $12.02 Median $21.88 Typical High $39.81 | Facility | 56 · Pre-op care only | $12.02 | $21.88 | $39.81 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $60.26 Median $107.15 Typical High $123.03 | Professional | 52 · Reduced service | $60.26 | $107.15 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $43.65 Typical High $48.98 | Professional | 53 · Discontinued | $23.99 | $43.65 | $48.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $91.20 Median $162.18 Typical High $186.21 | Professional | 54 · Surgery only | $91.20 | $162.18 | $186.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $32.36 Typical High $37.15 | Professional | 55 · Aftercare only | $18.20 | $32.36 | $37.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $21.88 Typical High $24.55 | Professional | 56 · Pre-op care only | $12.02 | $21.88 | $24.55 |
Where Kentucky sits
The same service costs 5.8 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
$195
AK $955HI $166
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.