How much rates vary
Facilitymedian $339 · 10th to 90th $100 to $3,311Professionalmedian $437 · 10th to 90th $200 to $1,549
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 $213.80 Median $562.34 Typical High $1,445.44 | Facility | None | $213.80 | $562.34 | $1,445.44 |
Aetna Setting Professional Modifier None Typical Low $213.80 Median $575.44 Typical High $1,513.56 | Professional | None | $213.80 | $575.44 | $1,513.56 |
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 $186.21 Median $371.54 Typical High $1,000.00 | Professional | None | $186.21 | $371.54 | $1,000.00 |
CareSource Setting Facility Modifier None Typical Low $165.96 Median $199.53 Typical High $316.23 | Facility | None | $165.96 | $199.53 | $316.23 |
CareSource Setting Professional Modifier None Typical Low $213.80 Median $275.42 Typical High $323.59 | Professional | None | $213.80 | $275.42 | $323.59 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $338.84 Typical High $338.84 | Facility | None | $34.67 | $338.84 | $338.84 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $912.01 Typical High $5,128.61 | Professional | None | $199.53 | $912.01 | $5,128.61 |
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 $245.47 Median $602.56 Typical High $1,949.84 | Professional | None | $245.47 | $602.56 | $1,949.84 |
11 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 $107.15 Median $144.54 Typical High $630.96 | Facility | 52 · Reduced service | $107.15 | $144.54 | $630.96 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $42.66 Median $58.88 Typical High $251.19 | Facility | 53 · Discontinued | $42.66 | $58.88 | $251.19 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $162.18 Median $218.78 Typical High $954.99 | Facility | 54 · Surgery only | $162.18 | $218.78 | $954.99 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $32.36 Median $43.65 Typical High $190.55 | Facility | 55 · Aftercare only | $32.36 | $43.65 | $190.55 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $21.38 Median $28.84 Typical High $125.89 | Facility | 56 · Pre-op care only | $21.38 | $28.84 | $125.89 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $107.15 Median $190.55 Typical High $676.08 | Professional | 52 · Reduced service | $107.15 | $190.55 | $676.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $42.66 Median $75.86 Typical High $269.15 | Professional | 53 · Discontinued | $42.66 | $75.86 | $269.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $162.18 Median $281.84 Typical High $1,023.29 | Professional | 54 · Surgery only | $162.18 | $281.84 | $1,023.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $32.36 Median $56.23 Typical High $204.17 | Professional | 55 · Aftercare only | $32.36 | $56.23 | $204.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.38 Median $38.02 Typical High $134.90 | Professional | 56 · Pre-op care only | $21.38 | $38.02 | $134.90 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $162.18 Median $162.18 Typical High $251.19 | Professional | 59 · Distinct service | $162.18 | $162.18 | $251.19 |
Where Kentucky sits
The same service costs 4.1 times more in Washington 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· 48th of 51
$437
WA $1,549NE $380
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.