How much rates vary
Facilitymedian $182 · 10th to 90th $107 to $1,479Professionalmedian $186 · 10th to 90th $115 to $282
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 $114.82 Median $186.21 Typical High $794.33 | Facility | None | $114.82 | $186.21 | $794.33 |
Aetna Setting Professional Modifier None Typical Low $114.82 Median $181.97 Typical High $257.04 | Professional | None | $114.82 | $181.97 | $257.04 |
Ambetter Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $218.78 | Professional | None | $218.78 | $218.78 | $218.78 |
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 $120.23 Median $181.97 Typical High $275.42 | Professional | None | $120.23 | $181.97 | $275.42 |
CareSource Setting Facility Modifier None Typical Low $107.15 Median $154.88 Typical High $204.17 | Facility | None | $107.15 | $154.88 | $204.17 |
CareSource Setting Professional Modifier None Typical Low $138.04 Median $177.83 Typical High $245.47 | Professional | None | $138.04 | $177.83 | $245.47 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $147.91 Typical High $398.11 | Facility | None | $34.67 | $147.91 | $398.11 |
Cigna Setting Professional Modifier None Typical Low $112.20 Median $213.80 Typical High $1,230.27 | Professional | None | $112.20 | $213.80 | $1,230.27 |
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 $141.25 Median $208.93 Typical High $323.59 | Professional | None | $141.25 | $208.93 | $323.59 |
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 $57.54 Median $91.20 Typical High $114.82 | Facility | 52 · Reduced service | $57.54 | $91.20 | $114.82 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $22.91 Median $36.31 Typical High $45.71 | Facility | 53 · Discontinued | $22.91 | $36.31 | $45.71 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $87.10 Median $138.04 Typical High $173.78 | Facility | 54 · Surgery only | $87.10 | $138.04 | $173.78 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $17.38 Median $27.54 Typical High $34.67 | Facility | 55 · Aftercare only | $17.38 | $27.54 | $34.67 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $11.48 Median $18.20 Typical High $22.91 | Facility | 56 · Pre-op care only | $11.48 | $18.20 | $22.91 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $57.54 Median $91.20 Typical High $107.15 | Professional | 52 · Reduced service | $57.54 | $91.20 | $107.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $36.31 Typical High $43.65 | Professional | 53 · Discontinued | $22.91 | $36.31 | $43.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $87.10 Median $134.90 Typical High $162.18 | Professional | 54 · Surgery only | $87.10 | $134.90 | $162.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $27.54 Typical High $32.36 | Professional | 55 · Aftercare only | $17.38 | $27.54 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $18.20 Typical High $21.38 | Professional | 56 · Pre-op care only | $11.48 | $18.20 | $21.38 |
Where Kentucky sits
The same service costs 3.0 times more in Wisconsin 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
$186
WI $537MD $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.