How much rates vary
Facilitymedian $2,138 · 10th to 90th $162 to $8,128Professionalmedian $166 · 10th to 90th $115 to $4,074
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 $162.18 Median $1,230.27 Typical High $3,235.94 | Facility | None | $162.18 | $1,230.27 | $3,235.94 |
Aetna Setting Professional Modifier None Typical Low $162.18 Median $2,137.96 Typical High $3,090.30 | Professional | None | $162.18 | $2,137.96 | $3,090.30 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,000.00 Median $8,912.51 Typical High $11,220.18 | Facility | None | $1,000.00 | $8,912.51 | $11,220.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $109.65 Median $131.83 Typical High $158.49 | Professional | None | $109.65 | $131.83 | $158.49 |
CareSource Setting Facility Modifier None Typical Low $151.36 Median $251.19 Typical High $7,079.46 | Facility | None | $151.36 | $251.19 | $7,079.46 |
CareSource Setting Professional Modifier None Typical Low $154.88 Median $218.78 Typical High $257.04 | Professional | None | $154.88 | $218.78 | $257.04 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $831.76 Typical High $5,011.87 | Facility | None | $34.67 | $831.76 | $5,011.87 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $2,187.76 Typical High $11,481.54 | Professional | None | $158.49 | $2,187.76 | $11,481.54 |
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 $831.76 Median $2,290.87 Typical High $6,760.83 | Facility | None | $831.76 | $2,290.87 | $6,760.83 |
United Setting Professional Modifier None Typical Low $165.96 Median $2,137.96 Typical High $4,677.35 | Professional | None | $165.96 | $2,137.96 | $4,677.35 |
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 $81.28 Median $102.33 Typical High $1,621.81 | Facility | 52 · Reduced service | $81.28 | $102.33 | $1,621.81 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $33.11 Median $40.74 Typical High $660.69 | Facility | 53 · Discontinued | $33.11 | $40.74 | $660.69 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $123.03 Median $154.88 Typical High $2,454.71 | Facility | 54 · Surgery only | $123.03 | $154.88 | $2,454.71 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $24.55 Median $30.90 Typical High $489.78 | Facility | 55 · Aftercare only | $24.55 | $30.90 | $489.78 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $16.22 Median $20.42 Typical High $323.59 | Facility | 56 · Pre-op care only | $16.22 | $20.42 | $323.59 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $81.28 Median $123.03 Typical High $1,258.93 | Professional | 52 · Reduced service | $81.28 | $123.03 | $1,258.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $48.98 Typical High $501.19 | Professional | 53 · Discontinued | $33.11 | $48.98 | $501.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $123.03 Median $186.21 Typical High $1,949.84 | Professional | 54 · Surgery only | $123.03 | $186.21 | $1,949.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $37.15 Typical High $380.19 | Professional | 55 · Aftercare only | $24.55 | $37.15 | $380.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $24.55 Typical High $251.19 | Professional | 56 · Pre-op care only | $16.22 | $24.55 | $251.19 |
Where Kentucky sits
The same service costs 33.1 times more in Alaska than in Kentucky. 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· 51st of 51
$166
AK $5,495KY $166
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.