How much rates vary
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 $9.33 Median $29.51 Typical High $39.81 | Facility | None | $9.33 | $29.51 | $39.81 |
Aetna Setting Professional Modifier None Typical Low $9.33 Median $26.92 Typical High $45.71 | Professional | None | $9.33 | $26.92 | $45.71 |
Anthem BCBS Setting Facility Modifier None Typical Low $758.58 Median $9,549.93 Typical High $11,220.18 | Facility | None | $758.58 | $9,549.93 | $11,220.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $8.32 Median $19.95 Typical High $38.02 | Professional | None | $8.32 | $19.95 | $38.02 |
CareSource Setting Facility Modifier None Typical Low $8.13 Median $524.81 Typical High $933.25 | Facility | None | $8.13 | $524.81 | $933.25 |
CareSource Setting Professional Modifier None Typical Low $10.00 Median $16.98 Typical High $38.90 | Professional | None | $10.00 | $16.98 | $38.90 |
Cigna Setting Facility Modifier None Typical Low $14.45 Median $14.45 Typical High $34.67 | Facility | None | $14.45 | $14.45 | $34.67 |
Cigna Setting Professional Modifier None Typical Low $10.23 Median $30.90 Typical High $186.21 | Professional | None | $10.23 | $30.90 | $186.21 |
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 $11.75 Median $21.88 Typical High $45.71 | Professional | None | $11.75 | $21.88 | $45.71 |
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 $4.57 Median $14.79 Typical High $19.95 | Facility | 52 · Reduced service | $4.57 | $14.79 | $19.95 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $1.86 Median $6.03 Typical High $7.94 | Facility | 53 · Discontinued | $1.86 | $6.03 | $7.94 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $6.92 Median $22.39 Typical High $30.20 | Facility | 54 · Surgery only | $6.92 | $22.39 | $30.20 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $1.38 Median $4.47 Typical High $6.03 | Facility | 55 · Aftercare only | $1.38 | $4.47 | $6.03 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $0.91 Median $2.95 Typical High $3.98 | Facility | 56 · Pre-op care only | $0.91 | $2.95 | $3.98 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $4.57 Median $14.79 Typical High $20.89 | Professional | 52 · Reduced service | $4.57 | $14.79 | $20.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.86 Median $6.03 Typical High $8.32 | Professional | 53 · Discontinued | $1.86 | $6.03 | $8.32 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $6.92 Median $22.39 Typical High $30.90 | Professional | 54 · Surgery only | $6.92 | $22.39 | $30.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.38 Median $4.47 Typical High $6.17 | Professional | 55 · Aftercare only | $1.38 | $4.47 | $6.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.91 Median $2.95 Typical High $4.17 | Professional | 56 · Pre-op care only | $0.91 | $2.95 | $4.17 |
Where Kentucky sits
The same service costs 4.2 times more in Wisconsin than in Nebraska. 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· 50th of 51
$20.89
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.