How much rates vary
Facilitymedian $4,677 · 10th to 90th $479 to $13,490Professionalmedian $1,318 · 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 $3,467.37 | Facility | None | $371.54 | $851.14 | $3,467.37 |
Aetna Setting Professional Modifier None Typical Low $371.54 Median $1,479.11 Typical High $2,951.21 | Professional | None | $371.54 | $1,479.11 | $2,951.21 |
Ambetter Setting Professional Modifier None Typical Low $181.97 Median $398.11 Typical High $398.11 | Professional | None | $181.97 | $398.11 | $398.11 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,801.89 Median $6,606.93 Typical High $14,454.40 | Facility | None | $3,801.89 | $6,606.93 | $14,454.40 |
Anthem BCBS Setting Professional Modifier None Typical Low $295.12 Median $1,148.15 Typical High $2,089.30 | Professional | None | $295.12 | $1,148.15 | $2,089.30 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $436.52 Median $1,737.80 Typical High $3,162.28 | Professional | 50 · Both sides | $436.52 | $1,737.80 | $3,162.28 |
CareSource Setting Facility Modifier None Typical Low $288.40 Median $346.74 Typical High $537.03 | Facility | None | $288.40 | $346.74 | $537.03 |
CareSource Setting Professional Modifier None Typical Low $478.63 Median $1,819.70 Typical High $2,454.71 | Professional | None | $478.63 | $1,819.70 | $2,454.71 |
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 $1,778.28 Typical High $10,964.78 | Professional | None | $346.74 | $1,778.28 | $10,964.78 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $288.40 | Professional | None | $33.11 | $33.11 | $288.40 |
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 $416.87 Median $1,659.59 Typical High $3,090.30 | Professional | None | $416.87 | $1,659.59 | $3,090.30 |
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 $1,258.93 | Facility | 52 · Reduced service | $186.21 | $251.19 | $1,258.93 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $74.13 Median $100.00 Typical High $501.19 | Facility | 53 · Discontinued | $74.13 | $100.00 | $501.19 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $281.84 Median $371.54 Typical High $1,862.09 | Facility | 54 · Surgery only | $281.84 | $371.54 | $1,862.09 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $56.23 Median $74.13 Typical High $371.54 | Facility | 55 · Aftercare only | $56.23 | $74.13 | $371.54 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $37.15 Median $50.12 Typical High $251.19 | Facility | 56 · Pre-op care only | $37.15 | $50.12 | $251.19 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $186.21 Median $724.44 Typical High $1,258.93 | Professional | 52 · Reduced service | $186.21 | $724.44 | $1,258.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $295.12 Typical High $501.19 | Professional | 53 · Discontinued | $74.13 | $295.12 | $501.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $281.84 Median $1,096.48 Typical High $1,862.09 | Professional | 54 · Surgery only | $281.84 | $1,096.48 | $1,862.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $223.87 Typical High $371.54 | Professional | 55 · Aftercare only | $56.23 | $223.87 | $371.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $147.91 Typical High $251.19 | Professional | 56 · Pre-op care only | $37.15 | $147.91 | $251.19 |
Where Kentucky sits
The same service costs 6.2 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· 44th of 51
$1,349
WA $3,162MD $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.