How much rates vary
Facilitymedian $1,660 · 10th to 90th $200 to $4,169Professionalmedian $186 · 10th to 90th $115 to $275
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 $125.89 Median $204.17 Typical High $851.14 | Facility | None | $125.89 | $204.17 | $851.14 |
Aetna Setting Professional Modifier None Typical Low $125.89 Median $199.53 Typical High $223.87 | Professional | None | $125.89 | $199.53 | $223.87 |
Anthem BCBS Setting Facility Modifier None Typical Low $724.44 Median $1,995.26 Typical High $4,265.80 | Facility | None | $724.44 | $1,995.26 | $4,265.80 |
Anthem BCBS Setting Professional Modifier None Typical Low $112.20 Median $177.83 Typical High $257.04 | Professional | None | $112.20 | $177.83 | $257.04 |
CareSource Setting Facility Modifier None Typical Low $117.49 Median $190.55 Typical High $2,691.53 | Facility | None | $117.49 | $190.55 | $2,691.53 |
CareSource Setting Professional Modifier None Typical Low $117.49 Median $162.18 Typical High $194.98 | Professional | None | $117.49 | $162.18 | $194.98 |
Cigna Setting Facility Modifier None Typical Low $199.53 Median $1,659.59 Typical High $2,041.74 | Facility | None | $199.53 | $1,659.59 | $2,041.74 |
Cigna Setting Professional Modifier None Typical Low $123.03 Median $204.17 Typical High $1,174.90 | Professional | None | $123.03 | $204.17 | $1,174.90 |
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 $707.95 Median $1,174.90 Typical High $3,890.45 | Facility | None | $707.95 | $1,174.90 | $3,890.45 |
United Setting Professional Modifier None Typical Low $128.82 Median $204.17 Typical High $331.13 | Professional | None | $128.82 | $204.17 | $331.13 |
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 $63.10 Median $100.00 Typical High $112.20 | Facility | 52 · Reduced service | $63.10 | $100.00 | $112.20 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $25.12 Median $40.74 Typical High $44.67 | Facility | 53 · Discontinued | $25.12 | $40.74 | $44.67 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $93.33 Median $151.36 Typical High $165.96 | Facility | 54 · Surgery only | $93.33 | $151.36 | $165.96 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $18.62 Median $30.20 Typical High $33.88 | Facility | 55 · Aftercare only | $18.62 | $30.20 | $33.88 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $12.59 Median $20.42 Typical High $22.39 | Facility | 56 · Pre-op care only | $12.59 | $20.42 | $22.39 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $63.10 Median $100.00 Typical High $112.20 | Professional | 52 · Reduced service | $63.10 | $100.00 | $112.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $39.81 Typical High $44.67 | Professional | 53 · Discontinued | $25.12 | $39.81 | $44.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $93.33 Median $151.36 Typical High $165.96 | Professional | 54 · Surgery only | $93.33 | $151.36 | $165.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $30.20 Typical High $33.88 | Professional | 55 · Aftercare only | $18.62 | $30.20 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $19.95 Typical High $22.39 | Professional | 56 · Pre-op care only | $12.59 | $19.95 | $22.39 |
Where Kentucky sits
The same service costs 3.7 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
$191
AK $708KY $191
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.