How much rates vary
Facilitymedian $240 · 10th to 90th $100 to $3,311Professionalmedian $282 · 10th to 90th $129 to $741
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 $154.88 Median $416.87 Typical High $851.14 | Facility | None | $154.88 | $416.87 | $851.14 |
Aetna Setting Professional Modifier None Typical Low $154.88 Median $346.74 Typical High $758.58 | Professional | None | $154.88 | $346.74 | $758.58 |
Anthem BCBS Setting Facility Modifier None Typical Low $9,120.11 Median $10,715.19 Typical High $11,220.18 | Facility | None | $9,120.11 | $10,715.19 | $11,220.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $128.82 Median $257.04 Typical High $478.63 | Professional | None | $128.82 | $257.04 | $478.63 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $194.98 Median $389.05 Typical High $707.95 | Professional | 50 · Both sides | $194.98 | $389.05 | $707.95 |
CareSource Setting Facility Modifier None Typical Low $120.23 Median $141.25 Typical High $223.87 | Facility | None | $120.23 | $141.25 | $223.87 |
CareSource Setting Professional Modifier None Typical Low $125.89 Median $190.55 Typical High $229.09 | Professional | None | $125.89 | $190.55 | $229.09 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $239.88 Typical High $239.88 | Facility | None | $34.67 | $239.88 | $239.88 |
Cigna Setting Professional Modifier None Typical Low $144.54 Median $478.63 Typical High $2,511.89 | Professional | None | $144.54 | $478.63 | $2,511.89 |
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 $50.12 Median $416.87 Typical High $1,949.84 | Facility | None | $50.12 | $416.87 | $1,949.84 |
United Setting Professional Modifier None Typical Low $162.18 Median $389.05 Typical High $933.25 | Professional | None | $162.18 | $389.05 | $933.25 |
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 $77.62 Median $102.33 Typical High $338.84 | Facility | 52 · Reduced service | $77.62 | $102.33 | $338.84 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $30.90 Median $40.74 Typical High $134.90 | Facility | 53 · Discontinued | $30.90 | $40.74 | $134.90 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $114.82 Median $154.88 Typical High $501.19 | Facility | 54 · Surgery only | $114.82 | $154.88 | $501.19 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $22.91 Median $30.90 Typical High $102.33 | Facility | 55 · Aftercare only | $22.91 | $30.90 | $102.33 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $15.49 Median $20.42 Typical High $67.61 | Facility | 56 · Pre-op care only | $15.49 | $20.42 | $67.61 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $77.62 Median $141.25 Typical High $363.08 | Professional | 52 · Reduced service | $77.62 | $141.25 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $56.23 Typical High $144.54 | Professional | 53 · Discontinued | $30.90 | $56.23 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $208.93 Typical High $549.54 | Professional | 54 · Surgery only | $114.82 | $208.93 | $549.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $41.69 Typical High $109.65 | Professional | 55 · Aftercare only | $22.91 | $41.69 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $28.18 Typical High $72.44 | Professional | 56 · Pre-op care only | $15.49 | $28.18 | $72.44 |
Where Kentucky sits
The same service costs 3.5 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· 49th of 51
$282
WI $912NE $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.