How much rates vary
Facilitymedian $100 · 10th to 90th $54 to $1,380Professionalmedian $74 · 10th to 90th $50 to $126
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 $50.12 Median $81.28 Typical High $398.11 | Facility | None | $50.12 | $81.28 | $398.11 |
Aetna Setting Professional Modifier None Typical Low $50.12 Median $81.28 Typical High $125.89 | Professional | None | $50.12 | $81.28 | $125.89 |
Ambetter Setting Professional Modifier None Typical Low $69.18 Median $102.33 Typical High $134.90 | Professional | None | $69.18 | $102.33 | $134.90 |
Ambetter Setting Professional Modifier 50 · Both sides Typical Low $91.20 Median $138.04 Typical High $181.97 | Professional | 50 · Both sides | $91.20 | $138.04 | $181.97 |
Anthem BCBS Setting Facility Modifier None Typical Low $575.44 Median $3,801.89 Typical High $11,220.18 | Facility | None | $575.44 | $3,801.89 | $11,220.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $43.65 Median $61.66 Typical High $95.50 | Professional | None | $43.65 | $61.66 | $95.50 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $64.57 Median $93.33 Typical High $141.25 | Professional | 50 · Both sides | $64.57 | $93.33 | $141.25 |
CareSource Setting Facility Modifier None Typical Low $53.70 Median $74.13 Typical High $93.33 | Facility | None | $53.70 | $74.13 | $93.33 |
CareSource Setting Professional Modifier None Typical Low $75.86 Median $91.20 Typical High $125.89 | Professional | None | $75.86 | $91.20 | $125.89 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $75.86 Typical High $691.83 | Facility | None | $34.67 | $75.86 | $691.83 |
Cigna Setting Professional Modifier None Typical Low $56.23 Median $91.20 Typical High $501.19 | Professional | None | $56.23 | $91.20 | $501.19 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $56.23 | Professional | None | $33.11 | $33.11 | $56.23 |
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 $66.07 Median $95.50 Typical High $154.88 | Professional | None | $66.07 | $95.50 | $154.88 |
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 $25.12 Median $38.90 Typical High $56.23 | Facility | 52 · Reduced service | $25.12 | $38.90 | $56.23 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $10.00 Median $15.49 Typical High $22.39 | Facility | 53 · Discontinued | $10.00 | $15.49 | $22.39 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $38.02 Median $58.88 Typical High $83.18 | Facility | 54 · Surgery only | $38.02 | $58.88 | $83.18 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $7.59 Median $11.75 Typical High $16.98 | Facility | 55 · Aftercare only | $7.59 | $11.75 | $16.98 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $5.01 Median $7.76 Typical High $11.22 | Facility | 56 · Pre-op care only | $5.01 | $7.76 | $11.22 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $25.12 Median $39.81 Typical High $51.29 | Professional | 52 · Reduced service | $25.12 | $39.81 | $51.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.00 Median $16.22 Typical High $20.42 | Professional | 53 · Discontinued | $10.00 | $16.22 | $20.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $38.02 Median $60.26 Typical High $75.86 | Professional | 54 · Surgery only | $38.02 | $60.26 | $75.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.59 Median $12.02 Typical High $15.14 | Professional | 55 · Aftercare only | $7.59 | $12.02 | $15.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.01 Median $7.94 Typical High $10.23 | Professional | 56 · Pre-op care only | $5.01 | $7.94 | $10.23 |
Where Kentucky sits
The same service costs 3.7 times more in Alaska than in Kentucky. 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· 51st of 51
$74.13
AK $275KY $74.13
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.