How much rates vary
Facilitymedian $166 · 10th to 90th $37 to $3,311Professionalmedian $65 · 10th to 90th $37 to $263
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 $37.15 Median $165.96 Typical High $851.14 | Facility | None | $37.15 | $165.96 | $851.14 |
Aetna Setting Professional Modifier None Typical Low $37.15 Median $147.91 Typical High $218.78 | Professional | None | $37.15 | $147.91 | $218.78 |
Anthem BCBS Setting Facility Modifier None Typical Low $9,120.11 Median $10,715.19 Typical High $11,220.18 | Facility | None | $9,120.11 | $10,715.19 | $11,220.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $37.15 Median $46.77 Typical High $74.13 | Professional | None | $37.15 | $46.77 | $74.13 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $43.65 Median $66.07 Typical High $102.33 | Professional | 50 · Both sides | $43.65 | $66.07 | $102.33 |
CareSource Setting Facility Modifier None Typical Low $34.67 Median $41.69 Typical High $64.57 | Facility | None | $34.67 | $41.69 | $64.57 |
CareSource Setting Professional Modifier None Typical Low $39.81 Median $57.54 Typical High $67.61 | Professional | None | $39.81 | $57.54 | $67.61 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $69.18 Typical High $69.18 | Facility | None | $34.67 | $69.18 | $69.18 |
Cigna Setting Professional Modifier None Typical Low $41.69 Median $190.55 Typical High $1,949.84 | Professional | None | $41.69 | $190.55 | $1,949.84 |
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 $50.12 Median $416.87 Typical High $1,949.84 | Facility | None | $50.12 | $416.87 | $1,949.84 |
United Setting Professional Modifier None Typical Low $45.71 Median $147.91 Typical High $263.03 | Professional | None | $45.71 | $147.91 | $263.03 |
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 $18.62 Median $83.18 Typical High $181.97 | Facility | 52 · Reduced service | $18.62 | $83.18 | $181.97 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $7.59 Median $33.11 Typical High $72.44 | Facility | 53 · Discontinued | $7.59 | $33.11 | $72.44 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $28.18 Median $123.03 Typical High $269.15 | Facility | 54 · Surgery only | $28.18 | $123.03 | $269.15 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $5.62 Median $24.55 Typical High $53.70 | Facility | 55 · Aftercare only | $5.62 | $24.55 | $53.70 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $3.72 Median $16.60 Typical High $36.31 | Facility | 56 · Pre-op care only | $3.72 | $16.60 | $36.31 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $18.62 Median $72.44 Typical High $107.15 | Professional | 52 · Reduced service | $18.62 | $72.44 | $107.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.59 Median $29.51 Typical High $42.66 | Professional | 53 · Discontinued | $7.59 | $29.51 | $42.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $28.18 Median $109.65 Typical High $158.49 | Professional | 54 · Surgery only | $28.18 | $109.65 | $158.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.62 Median $22.39 Typical High $31.62 | Professional | 55 · Aftercare only | $5.62 | $22.39 | $31.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.72 Median $14.79 Typical High $21.38 | Professional | 56 · Pre-op care only | $3.72 | $14.79 | $21.38 |
Where Kentucky sits
The same service costs 5.8 times more in Washington than in Virginia. 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
$66.07
WA $331VA $57.54
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.