How much rates vary
Facilitymedian $891 · 10th to 90th $200 to $7,762Professionalmedian $776 · 10th to 90th $178 to $1,698
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 $199.53 Median $851.14 Typical High $1,513.56 | Facility | None | $199.53 | $851.14 | $1,513.56 |
Aetna Setting Professional Modifier None Typical Low $199.53 Median $870.96 Typical High $1,479.11 | Professional | None | $199.53 | $870.96 | $1,479.11 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,888.44 Median $9,120.11 Typical High $11,220.18 | Facility | None | $5,888.44 | $9,120.11 | $11,220.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $173.78 Median $676.08 Typical High $1,230.27 | Professional | None | $173.78 | $676.08 | $1,230.27 |
CareSource Setting Facility Modifier None Typical Low $154.88 Median $186.21 Typical High $295.12 | Facility | None | $154.88 | $186.21 | $295.12 |
CareSource Setting Professional Modifier None Typical Low $181.97 Median $245.47 Typical High $295.12 | Professional | None | $181.97 | $245.47 | $295.12 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $316.23 Typical High $316.23 | Facility | None | $34.67 | $316.23 | $316.23 |
Cigna Setting Professional Modifier None Typical Low $186.21 Median $870.96 Typical High $4,786.30 | Professional | None | $186.21 | $870.96 | $4,786.30 |
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 $741.31 Median $4,073.80 Typical High $8,511.38 | Facility | None | $741.31 | $4,073.80 | $8,511.38 |
United Setting Professional Modifier None Typical Low $239.88 Median $954.99 Typical High $1,949.84 | Professional | None | $239.88 | $954.99 | $1,949.84 |
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 $100.00 Median $151.36 Typical High $758.58 | Facility | 52 · Reduced service | $100.00 | $151.36 | $758.58 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $40.74 Median $60.26 Typical High $302.00 | Facility | 53 · Discontinued | $40.74 | $60.26 | $302.00 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $151.36 Median $229.09 Typical High $1,148.15 | Facility | 54 · Surgery only | $151.36 | $229.09 | $1,148.15 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $30.20 Median $45.71 Typical High $229.09 | Facility | 55 · Aftercare only | $30.20 | $45.71 | $229.09 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $19.95 Median $30.20 Typical High $151.36 | Facility | 56 · Pre-op care only | $19.95 | $30.20 | $151.36 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $100.00 Median $407.38 Typical High $707.95 | Professional | 52 · Reduced service | $100.00 | $407.38 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $162.18 Typical High $281.84 | Professional | 53 · Discontinued | $40.74 | $162.18 | $281.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $151.36 Median $616.60 Typical High $1,071.52 | Professional | 54 · Surgery only | $151.36 | $616.60 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $123.03 Typical High $213.80 | Professional | 55 · Aftercare only | $30.20 | $123.03 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $81.28 Typical High $141.25 | Professional | 56 · Pre-op care only | $19.95 | $81.28 | $141.25 |
Where Kentucky sits
The same service costs 5.9 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· 41st of 51
$776
WI $1,622MD $275
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.