How much rates vary
Facilitymedian $1,072 · 10th to 90th $240 to $2,884Professionalmedian $251 · 10th to 90th $158 to $389
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 $245.47 Typical High $794.33 | Facility | None | $162.18 | $245.47 | $794.33 |
Aetna Setting Professional Modifier None Typical Low $162.18 Median $239.88 Typical High $380.19 | Professional | None | $162.18 | $239.88 | $380.19 |
Ambetter Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $245.47 | Professional | None | $245.47 | $245.47 | $245.47 |
Ambetter Setting Professional Modifier 50 · Both sides Typical Low $208.93 Median $208.93 Typical High $363.08 | Professional | 50 · Both sides | $208.93 | $208.93 | $363.08 |
Anthem BCBS Setting Facility Modifier None Typical Low $602.56 Median $1,698.24 Typical High $2,884.03 | Facility | None | $602.56 | $1,698.24 | $2,884.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $154.88 Median $251.19 Typical High $380.19 | Professional | None | $154.88 | $251.19 | $380.19 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $229.09 Median $371.54 Typical High $562.34 | Professional | 50 · Both sides | $229.09 | $371.54 | $562.34 |
CareSource Setting Facility Modifier None Typical Low $151.36 Median $245.47 Typical High $1,348.96 | Facility | None | $151.36 | $245.47 | $1,348.96 |
CareSource Setting Professional Modifier None Typical Low $154.88 Median $213.80 Typical High $257.04 | Professional | None | $154.88 | $213.80 | $257.04 |
Cigna Setting Facility Modifier None Typical Low $257.04 Median $977.24 Typical High $1,318.26 | Facility | None | $257.04 | $977.24 | $1,318.26 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $281.84 Typical High $1,621.81 | Professional | None | $158.49 | $281.84 | $1,621.81 |
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 $457.09 Median $794.33 Typical High $2,754.23 | Facility | None | $457.09 | $794.33 | $2,754.23 |
United Setting Professional Modifier None Typical Low $194.98 Median $288.40 Typical High $446.68 | Professional | None | $194.98 | $288.40 | $446.68 |
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 $120.23 Typical High $154.88 | Facility | 52 · Reduced service | $81.28 | $120.23 | $154.88 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $32.36 Median $48.98 Typical High $61.66 | Facility | 53 · Discontinued | $32.36 | $48.98 | $61.66 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $120.23 Median $181.97 Typical High $234.42 | Facility | 54 · Surgery only | $120.23 | $181.97 | $234.42 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $23.99 Median $36.31 Typical High $46.77 | Facility | 55 · Aftercare only | $23.99 | $36.31 | $46.77 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $16.22 Median $23.99 Typical High $30.90 | Facility | 56 · Pre-op care only | $16.22 | $23.99 | $30.90 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $81.28 Median $120.23 Typical High $141.25 | Professional | 52 · Reduced service | $81.28 | $120.23 | $141.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $47.86 Typical High $56.23 | Professional | 53 · Discontinued | $32.36 | $47.86 | $56.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $181.97 Typical High $213.80 | Professional | 54 · Surgery only | $120.23 | $181.97 | $213.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $36.31 Typical High $42.66 | Professional | 55 · Aftercare only | $23.99 | $36.31 | $42.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $23.99 Typical High $28.18 | Professional | 56 · Pre-op care only | $16.22 | $23.99 | $28.18 |
Where Kentucky sits
The same service costs 3.1 times more in Alaska than in New York. 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
$263
AK $794NY $257
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.