How much rates vary
Facilitymedian $1,000 · 10th to 90th $132 to $3,802Professionalmedian $195 · 10th to 90th $123 to $331
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 $131.83 Median $251.19 Typical High $851.14 | Facility | None | $131.83 | $251.19 | $851.14 |
Aetna Setting Professional Modifier None Typical Low $131.83 Median $245.47 Typical High $295.12 | Professional | None | $131.83 | $245.47 | $295.12 |
Anthem BCBS Setting Facility Modifier None Typical Low $707.95 Median $1,995.26 Typical High $4,265.80 | Facility | None | $707.95 | $1,995.26 | $4,265.80 |
Anthem BCBS Setting Professional Modifier None Typical Low $117.49 Median $190.55 Typical High $263.03 | Professional | None | $117.49 | $190.55 | $263.03 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $177.83 Median $288.40 Typical High $398.11 | Professional | 50 · Both sides | $177.83 | $288.40 | $398.11 |
CareSource Setting Facility Modifier None Typical Low $120.23 Median $199.53 Typical High $354.81 | Facility | None | $120.23 | $199.53 | $354.81 |
CareSource Setting Professional Modifier None Typical Low $123.03 Median $173.78 Typical High $204.17 | Professional | None | $123.03 | $173.78 | $204.17 |
Cigna Setting Facility Modifier None Typical Low $208.93 Median $251.19 Typical High $1,659.59 | Facility | None | $208.93 | $251.19 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $128.82 Median $251.19 Typical High $1,318.26 | Professional | None | $128.82 | $251.19 | $1,318.26 |
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 $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 $138.04 Median $239.88 Typical High $380.19 | Professional | None | $138.04 | $239.88 | $380.19 |
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 $64.57 Median $107.15 Typical High $125.89 | Facility | 52 · Reduced service | $64.57 | $107.15 | $125.89 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $26.30 Median $42.66 Typical High $50.12 | Facility | 53 · Discontinued | $26.30 | $42.66 | $50.12 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $97.72 Median $162.18 Typical High $190.55 | Facility | 54 · Surgery only | $97.72 | $162.18 | $190.55 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $19.50 Median $32.36 Typical High $38.02 | Facility | 55 · Aftercare only | $19.50 | $32.36 | $38.02 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $13.18 Median $21.38 Typical High $25.12 | Facility | 56 · Pre-op care only | $13.18 | $21.38 | $25.12 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $64.57 Median $107.15 Typical High $131.83 | Professional | 52 · Reduced service | $64.57 | $107.15 | $131.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $42.66 Typical High $52.48 | Professional | 53 · Discontinued | $26.30 | $42.66 | $52.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $97.72 Median $162.18 Typical High $199.53 | Professional | 54 · Surgery only | $97.72 | $162.18 | $199.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $32.36 Typical High $39.81 | Professional | 55 · Aftercare only | $19.50 | $32.36 | $39.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $21.38 Typical High $26.30 | Professional | 56 · Pre-op care only | $13.18 | $21.38 | $26.30 |
Where Kentucky sits
The same service costs 3.2 times more in Wisconsin 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
$204
WI $646KY $204
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.