How much rates vary
Facilitymedian $240 · 10th to 90th $69 to $3,311Professionalmedian $115 · 10th to 90th $69 to $490
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 $69.18 Median $239.88 Typical High $851.14 | Facility | None | $69.18 | $239.88 | $851.14 |
Aetna Setting Professional Modifier None Typical Low $69.18 Median $208.93 Typical High $371.54 | Professional | None | $69.18 | $208.93 | $371.54 |
Ambetter Setting Professional Modifier None Typical Low $38.90 Median $93.33 Typical High $93.33 | Professional | None | $38.90 | $93.33 | $93.33 |
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 $69.18 Median $83.18 Typical High $489.78 | Professional | None | $69.18 | $83.18 | $489.78 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $104.71 Median $125.89 Typical High $724.44 | Professional | 50 · Both sides | $104.71 | $125.89 | $724.44 |
CareSource Setting Facility Modifier None Typical Low $64.57 Median $77.62 Typical High $120.23 | Facility | None | $64.57 | $77.62 | $120.23 |
CareSource Setting Professional Modifier None Typical Low $75.86 Median $104.71 Typical High $125.89 | Professional | None | $75.86 | $104.71 | $125.89 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $125.89 Typical High $125.89 | Facility | None | $34.67 | $125.89 | $125.89 |
Cigna Setting Professional Modifier None Typical Low $77.62 Median $275.42 Typical High $2,818.38 | Professional | None | $77.62 | $275.42 | $2,818.38 |
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 $85.11 Median $218.78 Typical High $407.38 | Professional | None | $85.11 | $218.78 | $407.38 |
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 $34.67 Median $120.23 Typical High $263.03 | Facility | 52 · Reduced service | $34.67 | $120.23 | $263.03 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $13.80 Median $47.86 Typical High $104.71 | Facility | 53 · Discontinued | $13.80 | $47.86 | $104.71 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $52.48 Median $181.97 Typical High $389.05 | Facility | 54 · Surgery only | $52.48 | $181.97 | $389.05 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $10.47 Median $36.31 Typical High $77.62 | Facility | 55 · Aftercare only | $10.47 | $36.31 | $77.62 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $6.92 Median $23.99 Typical High $52.48 | Facility | 56 · Pre-op care only | $6.92 | $23.99 | $52.48 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $34.67 Median $117.49 Typical High $158.49 | Professional | 52 · Reduced service | $34.67 | $117.49 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $46.77 Typical High $63.10 | Professional | 53 · Discontinued | $13.80 | $46.77 | $63.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $52.48 Median $177.83 Typical High $234.42 | Professional | 54 · Surgery only | $52.48 | $177.83 | $234.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $35.48 Typical High $46.77 | Professional | 55 · Aftercare only | $10.47 | $35.48 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $23.44 Typical High $31.62 | Professional | 56 · Pre-op care only | $6.92 | $23.44 | $31.62 |
Where Kentucky sits
The same service costs 4.2 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
$117
WA $447VA $107
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.