How much rates vary
Facilitymedian $155 · 10th to 90th $62 to $3,311Professionalmedian $107 · 10th to 90th $65 to $479
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 $61.66 Median $154.88 Typical High $851.14 | Facility | None | $61.66 | $154.88 | $851.14 |
Aetna Setting Professional Modifier None Typical Low $61.66 Median $147.91 Typical High $251.19 | Professional | None | $61.66 | $147.91 | $251.19 |
Ambetter Setting Professional Modifier None Typical Low $208.93 Median $208.93 Typical High $208.93 | Professional | None | $208.93 | $208.93 | $208.93 |
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 $63.10 Median $79.43 Typical High $478.63 | Professional | None | $63.10 | $79.43 | $478.63 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $95.50 Median $120.23 Typical High $707.95 | Professional | 50 · Both sides | $95.50 | $120.23 | $707.95 |
CareSource Setting Facility Modifier None Typical Low $57.54 Median $69.18 Typical High $107.15 | Facility | None | $57.54 | $69.18 | $107.15 |
CareSource Setting Professional Modifier None Typical Low $67.61 Median $91.20 Typical High $107.15 | Professional | None | $67.61 | $91.20 | $107.15 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $109.65 Typical High $109.65 | Facility | None | $34.67 | $109.65 | $109.65 |
Cigna Setting Professional Modifier None Typical Low $69.18 Median $186.21 Typical High $2,630.27 | Professional | None | $69.18 | $186.21 | $2,630.27 |
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 $77.62 Median $158.49 Typical High $281.84 | Professional | None | $77.62 | $158.49 | $281.84 |
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 $30.90 Median $77.62 Typical High $239.88 | Facility | 52 · Reduced service | $30.90 | $77.62 | $239.88 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $12.30 Median $30.90 Typical High $97.72 | Facility | 53 · Discontinued | $12.30 | $30.90 | $97.72 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $46.77 Median $114.82 Typical High $363.08 | Facility | 54 · Surgery only | $46.77 | $114.82 | $363.08 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $9.33 Median $22.91 Typical High $72.44 | Facility | 55 · Aftercare only | $9.33 | $22.91 | $72.44 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $6.17 Median $15.49 Typical High $48.98 | Facility | 56 · Pre-op care only | $6.17 | $15.49 | $48.98 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $30.90 Median $75.86 Typical High $97.72 | Professional | 52 · Reduced service | $30.90 | $75.86 | $97.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.30 Median $30.20 Typical High $39.81 | Professional | 53 · Discontinued | $12.30 | $30.20 | $39.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $46.77 Median $112.20 Typical High $147.91 | Professional | 54 · Surgery only | $46.77 | $112.20 | $147.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.33 Median $22.39 Typical High $29.51 | Professional | 55 · Aftercare only | $9.33 | $22.39 | $29.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.17 Median $15.14 Typical High $19.95 | Professional | 56 · Pre-op care only | $6.17 | $15.14 | $19.95 |
Where Kentucky sits
The same service costs 3.8 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
$110
AK $363VA $95.50
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.