How much rates vary
Facilitymedian $54 · 10th to 90th $32 to $1,122Professionalmedian $49 · 10th to 90th $29 to $87
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 $30.90 Median $53.70 Typical High $416.87 | Facility | None | $30.90 | $53.70 | $416.87 |
Aetna Setting Professional Modifier None Typical Low $30.90 Median $43.65 Typical High $74.13 | Professional | None | $30.90 | $43.65 | $74.13 |
Ambetter Setting Professional Modifier None Typical Low $42.66 Median $48.98 Typical High $57.54 | Professional | None | $42.66 | $48.98 | $57.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $32.36 Median $32.36 Typical High $9,549.93 | Facility | None | $32.36 | $32.36 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $26.92 Median $47.86 Typical High $89.13 | Professional | None | $26.92 | $47.86 | $89.13 |
CareSource Setting Facility Modifier None Typical Low $33.11 Median $38.90 Typical High $53.70 | Facility | None | $33.11 | $38.90 | $53.70 |
CareSource Setting Professional Modifier None Typical Low $46.77 Median $50.12 Typical High $67.61 | Professional | None | $46.77 | $50.12 | $67.61 |
Cigna Setting Facility Modifier None Typical Low $30.90 Median $34.67 Typical High $398.11 | Facility | None | $30.90 | $34.67 | $398.11 |
Cigna Setting Professional Modifier None Typical Low $34.67 Median $53.70 Typical High $389.05 | Professional | None | $34.67 | $53.70 | $389.05 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $38.02 | Professional | None | $33.11 | $33.11 | $38.02 |
United Setting Facility Modifier None Typical Low $70.79 Median $186.21 Typical High $1,148.15 | Facility | None | $70.79 | $186.21 | $1,148.15 |
United Setting Professional Modifier None Typical Low $37.15 Median $52.48 Typical High $81.28 | Professional | None | $37.15 | $52.48 | $81.28 |
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 $15.49 Median $21.88 Typical High $37.15 | Facility | 52 · Reduced service | $15.49 | $21.88 | $37.15 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $6.17 Median $8.71 Typical High $14.79 | Facility | 53 · Discontinued | $6.17 | $8.71 | $14.79 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $23.44 Median $32.36 Typical High $54.95 | Facility | 54 · Surgery only | $23.44 | $32.36 | $54.95 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $4.68 Median $6.46 Typical High $10.96 | Facility | 55 · Aftercare only | $4.68 | $6.46 | $10.96 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $3.09 Median $4.37 Typical High $7.41 | Facility | 56 · Pre-op care only | $3.09 | $4.37 | $7.41 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $15.49 Median $21.88 Typical High $26.92 | Professional | 52 · Reduced service | $15.49 | $21.88 | $26.92 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.17 Median $8.71 Typical High $10.72 | Professional | 53 · Discontinued | $6.17 | $8.71 | $10.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $23.44 Median $32.36 Typical High $40.74 | Professional | 54 · Surgery only | $23.44 | $32.36 | $40.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.68 Median $6.46 Typical High $8.13 | Professional | 55 · Aftercare only | $4.68 | $6.46 | $8.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.09 Median $4.37 Typical High $5.37 | Professional | 56 · Pre-op care only | $3.09 | $4.37 | $5.37 |
Where Kentucky sits
The same service costs 4.2 times more in Alaska than in New York. 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· 48th of 51
$48.98
AK $186NY $44.67
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.