How much rates vary
Facilitymedian $126 · 10th to 90th $43 to $1,479Professionalmedian $79 · 10th to 90th $44 to $437
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 $48.98 Median $125.89 Typical High $338.84 | Facility | None | $48.98 | $125.89 | $338.84 |
Aetna Setting Professional Modifier None Typical Low $42.66 Median $123.03 Typical High $208.93 | Professional | None | $42.66 | $123.03 | $208.93 |
Ambetter Setting Professional Modifier None Typical Low $32.36 Median $33.11 Typical High $151.36 | Professional | None | $32.36 | $33.11 | $151.36 |
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 $42.66 Median $54.95 Typical High $436.52 | Professional | None | $42.66 | $54.95 | $436.52 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $64.57 Median $83.18 Typical High $645.65 | Professional | 50 · Both sides | $64.57 | $83.18 | $645.65 |
CareSource Setting Facility Modifier None Typical Low $38.90 Median $46.77 Typical High $74.13 | Facility | None | $38.90 | $46.77 | $74.13 |
CareSource Setting Professional Modifier None Typical Low $64.57 Median $147.91 Typical High $199.53 | Professional | None | $64.57 | $147.91 | $199.53 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $75.86 Typical High $75.86 | Facility | None | $34.67 | $75.86 | $75.86 |
Cigna Setting Professional Modifier None Typical Low $46.77 Median $154.88 Typical High $1,862.09 | Professional | None | $46.77 | $154.88 | $1,862.09 |
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 $52.48 Median $134.90 Typical High $239.88 | Professional | None | $52.48 | $134.90 | $239.88 |
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 $21.38 Median $63.10 Typical High $169.82 | Facility | 52 · Reduced service | $21.38 | $63.10 | $169.82 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $8.51 Median $25.12 Typical High $67.61 | Facility | 53 · Discontinued | $8.51 | $25.12 | $67.61 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $31.62 Median $95.50 Typical High $257.04 | Facility | 54 · Surgery only | $31.62 | $95.50 | $257.04 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $6.31 Median $19.05 Typical High $51.29 | Facility | 55 · Aftercare only | $6.31 | $19.05 | $51.29 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $4.27 Median $12.59 Typical High $33.88 | Facility | 56 · Pre-op care only | $4.27 | $12.59 | $33.88 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $21.38 Median $61.66 Typical High $83.18 | Professional | 52 · Reduced service | $21.38 | $61.66 | $83.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.51 Median $25.12 Typical High $33.11 | Professional | 53 · Discontinued | $8.51 | $25.12 | $33.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $31.62 Median $93.33 Typical High $123.03 | Professional | 54 · Surgery only | $31.62 | $93.33 | $123.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.31 Median $18.62 Typical High $24.55 | Professional | 55 · Aftercare only | $6.31 | $18.62 | $24.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.27 Median $12.30 Typical High $16.60 | Professional | 56 · Pre-op care only | $4.27 | $12.30 | $16.60 |
Where Kentucky sits
The same service costs 3.9 times more in Alaska 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
$79.43
AK $257VA $66.07
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.