How much rates vary
Facilitymedian $229 · 10th to 90th $87 to $1,380Professionalmedian $191 · 10th to 90th $120 to $316
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 $134.90 Median $229.09 Typical High $288.40 | Facility | None | $134.90 | $229.09 | $288.40 |
Aetna Setting Professional Modifier None Typical Low $134.90 Median $229.09 Typical High $288.40 | Professional | None | $134.90 | $229.09 | $288.40 |
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 $114.82 Median $144.54 Typical High $257.04 | Professional | None | $114.82 | $144.54 | $257.04 |
CareSource Setting Facility Modifier None Typical Low $144.54 Median $186.21 Typical High $239.88 | Facility | None | $144.54 | $186.21 | $239.88 |
CareSource Setting Professional Modifier None Typical Low $144.54 Median $199.53 Typical High $245.47 | Professional | None | $144.54 | $199.53 | $245.47 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $177.83 Typical High $263.03 | Facility | None | $34.67 | $177.83 | $263.03 |
Cigna Setting Professional Modifier None Typical Low $151.36 Median $257.04 Typical High $1,513.56 | Professional | None | $151.36 | $257.04 | $1,513.56 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $102.33 | Professional | None | $33.11 | $33.11 | $102.33 |
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 $158.49 Median $234.42 Typical High $371.54 | Professional | None | $158.49 | $234.42 | $371.54 |
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 $67.61 Median $112.20 Typical High $144.54 | Facility | 52 · Reduced service | $67.61 | $112.20 | $144.54 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $27.54 Median $45.71 Typical High $58.88 | Facility | 53 · Discontinued | $27.54 | $45.71 | $58.88 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $102.33 Median $169.82 Typical High $218.78 | Facility | 54 · Surgery only | $102.33 | $169.82 | $218.78 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $20.42 Median $33.88 Typical High $43.65 | Facility | 55 · Aftercare only | $20.42 | $33.88 | $43.65 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $13.49 Median $22.91 Typical High $28.84 | Facility | 56 · Pre-op care only | $13.49 | $22.91 | $28.84 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $67.61 Median $112.20 Typical High $144.54 | Professional | 52 · Reduced service | $67.61 | $112.20 | $144.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $45.71 Typical High $58.88 | Professional | 53 · Discontinued | $27.54 | $45.71 | $58.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $102.33 Median $169.82 Typical High $218.78 | Professional | 54 · Surgery only | $102.33 | $169.82 | $218.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.42 Median $33.88 Typical High $43.65 | Professional | 55 · Aftercare only | $20.42 | $33.88 | $43.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.49 Median $22.91 Typical High $28.84 | Professional | 56 · Pre-op care only | $13.49 | $22.91 | $28.84 |
Where Kentucky sits
The same service costs 3.6 times more in Alaska than in Maryland. 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· 49th of 51
$191
AK $661MD $182
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.