How much rates vary
Facilitymedian $550 · 10th to 90th $46 to $2,818Professionalmedian $62 · 10th to 90th $38 to $107
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 $38.90 Median $64.57 Typical High $398.11 | Facility | None | $38.90 | $64.57 | $398.11 |
Aetna Setting Professional Modifier None Typical Low $38.90 Median $54.95 Typical High $89.13 | Professional | None | $38.90 | $54.95 | $89.13 |
Ambetter Setting Professional Modifier None Typical Low $32.36 Median $64.57 Typical High $97.72 | Professional | None | $32.36 | $64.57 | $97.72 |
Ambetter Setting Professional Modifier 50 · Both sides Typical Low $72.44 Median $120.23 Typical High $134.90 | Professional | 50 · Both sides | $72.44 | $120.23 | $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 $33.88 Median $60.26 Typical High $123.03 | Professional | None | $33.88 | $60.26 | $123.03 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $51.29 Median $85.11 Typical High $204.17 | Professional | 50 · Both sides | $51.29 | $85.11 | $204.17 |
CareSource Setting Facility Modifier None Typical Low $40.74 Median $47.86 Typical High $67.61 | Facility | None | $40.74 | $47.86 | $67.61 |
CareSource Setting Professional Modifier None Typical Low $58.88 Median $63.10 Typical High $83.18 | Professional | None | $58.88 | $63.10 | $83.18 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $45.71 Typical High $398.11 | Facility | None | $34.67 | $45.71 | $398.11 |
Cigna Setting Professional Modifier None Typical Low $42.66 Median $64.57 Typical High $416.87 | Professional | None | $42.66 | $64.57 | $416.87 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $51.29 | Professional | None | $33.11 | $33.11 | $51.29 |
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 $50.12 Median $70.79 Typical High $107.15 | Professional | None | $50.12 | $70.79 | $107.15 |
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 $19.05 Median $26.92 Typical High $38.90 | Facility | 52 · Reduced service | $19.05 | $26.92 | $38.90 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $7.76 Median $10.96 Typical High $15.85 | Facility | 53 · Discontinued | $7.76 | $10.96 | $15.85 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $28.84 Median $40.74 Typical High $58.88 | Facility | 54 · Surgery only | $28.84 | $40.74 | $58.88 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $5.75 Median $8.13 Typical High $11.75 | Facility | 55 · Aftercare only | $5.75 | $8.13 | $11.75 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $3.89 Median $5.37 Typical High $7.76 | Facility | 56 · Pre-op care only | $3.89 | $5.37 | $7.76 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $19.05 Median $26.92 Typical High $33.88 | Professional | 52 · Reduced service | $19.05 | $26.92 | $33.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.76 Median $10.96 Typical High $13.49 | Professional | 53 · Discontinued | $7.76 | $10.96 | $13.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $28.84 Median $40.74 Typical High $50.12 | Professional | 54 · Surgery only | $28.84 | $40.74 | $50.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.75 Median $8.13 Typical High $10.00 | Professional | 55 · Aftercare only | $5.75 | $8.13 | $10.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.89 Median $5.37 Typical High $6.76 | Professional | 56 · Pre-op care only | $3.89 | $5.37 | $6.76 |
Where Kentucky sits
The same service costs 4.2 times more in Alaska than in Florida. 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
$63.10
AK $224FL $53.70
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.