How much rates vary
Facilitymedian $5,129 · 10th to 90th $479 to $14,454Professionalmedian $1,288 · 10th to 90th $324 to $2,884
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 $371.54 Median $851.14 Typical High $3,548.13 | Facility | None | $371.54 | $851.14 | $3,548.13 |
Aetna Setting Professional Modifier None Typical Low $371.54 Median $1,513.56 Typical High $3,019.95 | Professional | None | $371.54 | $1,513.56 | $3,019.95 |
Ambetter Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $398.11 | Professional | None | $398.11 | $398.11 | $398.11 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,168.69 Median $11,220.18 Typical High $16,218.10 | Facility | None | $4,168.69 | $11,220.18 | $16,218.10 |
Anthem BCBS Setting Professional Modifier None Typical Low $295.12 Median $1,148.15 Typical High $2,137.96 | Professional | None | $295.12 | $1,148.15 | $2,137.96 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $436.52 Median $1,698.24 Typical High $3,162.28 | Professional | 50 · Both sides | $436.52 | $1,698.24 | $3,162.28 |
CareSource Setting Facility Modifier None Typical Low $288.40 Median $354.81 Typical High $549.54 | Facility | None | $288.40 | $354.81 | $549.54 |
CareSource Setting Professional Modifier None Typical Low $478.63 Median $1,862.09 Typical High $2,511.89 | Professional | None | $478.63 | $1,862.09 | $2,511.89 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $588.84 Typical High $588.84 | Facility | None | $34.67 | $588.84 | $588.84 |
Cigna Setting Professional Modifier None Typical Low $346.74 Median $1,819.70 Typical High $11,220.18 | Professional | None | $346.74 | $1,819.70 | $11,220.18 |
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 $977.24 Median $7,413.10 Typical High $12,022.64 | Facility | None | $977.24 | $7,413.10 | $12,022.64 |
United Setting Professional Modifier None Typical Low $426.58 Median $1,737.80 Typical High $3,019.95 | Professional | None | $426.58 | $1,737.80 | $3,019.95 |
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 $186.21 Median $251.19 Typical High $1,288.25 | Facility | 52 · Reduced service | $186.21 | $251.19 | $1,288.25 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $74.13 Median $100.00 Typical High $512.86 | Facility | 53 · Discontinued | $74.13 | $100.00 | $512.86 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $281.84 Median $371.54 Typical High $1,905.46 | Facility | 54 · Surgery only | $281.84 | $371.54 | $1,905.46 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $56.23 Median $75.86 Typical High $380.19 | Facility | 55 · Aftercare only | $56.23 | $75.86 | $380.19 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $37.15 Median $50.12 Typical High $257.04 | Facility | 56 · Pre-op care only | $37.15 | $50.12 | $257.04 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $186.21 Median $724.44 Typical High $1,288.25 | Professional | 52 · Reduced service | $186.21 | $724.44 | $1,288.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $288.40 Typical High $512.86 | Professional | 53 · Discontinued | $74.13 | $288.40 | $512.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $281.84 Median $1,071.52 Typical High $1,949.84 | Professional | 54 · Surgery only | $281.84 | $1,071.52 | $1,949.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $213.80 Typical High $389.05 | Professional | 55 · Aftercare only | $56.23 | $213.80 | $389.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $144.54 Typical High $257.04 | Professional | 56 · Pre-op care only | $37.15 | $144.54 | $257.04 |
Where Kentucky sits
The same service costs 6.3 times more in Washington 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· 45th of 51
$1,349
WA $3,236MD $513
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.