How much rates vary
Facilitymedian $1,072 · 10th to 90th $288 to $7,762Professionalmedian $933 · 10th to 90th $251 to $2,089
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 $288.40 Median $851.14 Typical High $1,905.46 | Facility | None | $288.40 | $851.14 | $1,905.46 |
Aetna Setting Professional Modifier None Typical Low $288.40 Median $1,023.29 Typical High $1,819.70 | Professional | None | $288.40 | $1,023.29 | $1,819.70 |
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 $234.42 Median $794.33 Typical High $1,513.56 | Professional | None | $234.42 | $794.33 | $1,513.56 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $354.81 Median $1,174.90 Typical High $2,290.87 | Professional | 50 · Both sides | $354.81 | $1,174.90 | $2,290.87 |
CareSource Setting Facility Modifier None Typical Low $223.87 Median $269.15 Typical High $416.87 | Facility | None | $223.87 | $269.15 | $416.87 |
CareSource Setting Professional Modifier None Typical Low $288.40 Median $363.08 Typical High $436.52 | Professional | None | $288.40 | $363.08 | $436.52 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $446.68 Typical High $446.68 | Facility | None | $34.67 | $446.68 | $446.68 |
Cigna Setting Professional Modifier None Typical Low $269.15 Median $1,096.48 Typical High $6,025.60 | Professional | None | $269.15 | $1,096.48 | $6,025.60 |
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 $338.84 Median $1,148.15 Typical High $2,398.83 | Professional | None | $338.84 | $1,148.15 | $2,398.83 |
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 $144.54 Median $204.17 Typical High $954.99 | Facility | 52 · Reduced service | $144.54 | $204.17 | $954.99 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $57.54 Median $81.28 Typical High $380.19 | Facility | 53 · Discontinued | $57.54 | $81.28 | $380.19 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $218.78 Median $309.03 Typical High $1,412.54 | Facility | 54 · Surgery only | $218.78 | $309.03 | $1,412.54 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $43.65 Median $61.66 Typical High $281.84 | Facility | 55 · Aftercare only | $43.65 | $61.66 | $281.84 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $28.84 Median $40.74 Typical High $190.55 | Facility | 56 · Pre-op care only | $28.84 | $40.74 | $190.55 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $144.54 Median $478.63 Typical High $891.25 | Professional | 52 · Reduced service | $144.54 | $478.63 | $891.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $57.54 Median $190.55 Typical High $363.08 | Professional | 53 · Discontinued | $57.54 | $190.55 | $363.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $218.78 Median $724.44 Typical High $1,348.96 | Professional | 54 · Surgery only | $218.78 | $724.44 | $1,348.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $43.65 Median $144.54 Typical High $269.15 | Professional | 55 · Aftercare only | $43.65 | $144.54 | $269.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.84 Median $95.50 Typical High $181.97 | Professional | 56 · Pre-op care only | $28.84 | $95.50 | $181.97 |
Where Kentucky sits
The same service costs 5.1 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· 44th of 51
$933
WI $2,042MD $398
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.