How much rates vary
Facilitymedian $219 · 10th to 90th $100 to $3,311Professionalmedian $251 · 10th to 90th $123 to $851
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 $141.25 Median $537.03 Typical High $851.14 | Facility | None | $141.25 | $537.03 | $851.14 |
Aetna Setting Professional Modifier None Typical Low $141.25 Median $389.05 Typical High $851.14 | Professional | None | $141.25 | $389.05 | $851.14 |
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 $117.49 Median $251.19 Typical High $537.03 | Professional | None | $117.49 | $251.19 | $537.03 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $177.83 Median $380.19 Typical High $812.83 | Professional | 50 · Both sides | $177.83 | $380.19 | $812.83 |
CareSource Setting Facility Modifier None Typical Low $109.65 Median $131.83 Typical High $204.17 | Facility | None | $109.65 | $131.83 | $204.17 |
CareSource Setting Professional Modifier None Typical Low $117.49 Median $177.83 Typical High $208.93 | Professional | None | $117.49 | $177.83 | $208.93 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $218.78 Typical High $218.78 | Facility | None | $34.67 | $218.78 | $218.78 |
Cigna Setting Professional Modifier None Typical Low $131.83 Median $524.81 Typical High $2,754.23 | Professional | None | $131.83 | $524.81 | $2,754.23 |
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 $154.88 Median $398.11 Typical High $1,096.48 | Professional | None | $154.88 | $398.11 | $1,096.48 |
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 $70.79 Median $93.33 Typical High $363.08 | Facility | 52 · Reduced service | $70.79 | $93.33 | $363.08 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $28.18 Median $38.02 Typical High $144.54 | Facility | 53 · Discontinued | $28.18 | $38.02 | $144.54 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $104.71 Median $141.25 Typical High $537.03 | Facility | 54 · Surgery only | $104.71 | $141.25 | $537.03 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $20.89 Median $28.18 Typical High $107.15 | Facility | 55 · Aftercare only | $20.89 | $28.18 | $107.15 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $14.13 Median $19.05 Typical High $72.44 | Facility | 56 · Pre-op care only | $14.13 | $19.05 | $72.44 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $70.79 Median $125.89 Typical High $389.05 | Professional | 52 · Reduced service | $70.79 | $125.89 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $50.12 Typical High $154.88 | Professional | 53 · Discontinued | $28.18 | $50.12 | $154.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $190.55 Typical High $575.44 | Professional | 54 · Surgery only | $104.71 | $190.55 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $38.02 Typical High $117.49 | Professional | 55 · Aftercare only | $20.89 | $38.02 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $25.12 Typical High $77.62 | Professional | 56 · Pre-op care only | $14.13 | $25.12 | $77.62 |
Where Kentucky sits
The same service costs 3.8 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
$251
WI $912NE $240
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.