How much rates vary
Facilitymedian $417 · 10th to 90th $100 to $3,311Professionalmedian $447 · 10th to 90th $204 to $1,862
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 $239.88 Median $562.34 Typical High $2,290.87 | Facility | None | $239.88 | $562.34 | $2,290.87 |
Aetna Setting Professional Modifier None Typical Low $239.88 Median $691.83 Typical High $1,778.28 | Professional | None | $239.88 | $691.83 | $1,778.28 |
Ambetter Setting Professional Modifier None Typical Low $501.19 Median $501.19 Typical High $1,000.00 | Professional | None | $501.19 | $501.19 | $1,000.00 |
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 $199.53 Median $380.19 Typical High $1,122.02 | Professional | None | $199.53 | $380.19 | $1,122.02 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $302.00 Median $562.34 Typical High $1,659.59 | Professional | 50 · Both sides | $302.00 | $562.34 | $1,659.59 |
CareSource Setting Facility Modifier None Typical Low $181.97 Median $218.78 Typical High $346.74 | Facility | None | $181.97 | $218.78 | $346.74 |
CareSource Setting Professional Modifier None Typical Low $213.80 Median $288.40 Typical High $346.74 | Professional | None | $213.80 | $288.40 | $346.74 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $371.54 Typical High $371.54 | Facility | None | $34.67 | $371.54 | $371.54 |
Cigna Setting Professional Modifier None Typical Low $218.78 Median $1,096.48 Typical High $5,754.40 | Professional | None | $218.78 | $1,096.48 | $5,754.40 |
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 $257.04 Median $676.08 Typical High $2,187.76 | Professional | None | $257.04 | $676.08 | $2,187.76 |
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 $117.49 Median $158.49 Typical High $758.58 | Facility | 52 · Reduced service | $117.49 | $158.49 | $758.58 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $47.86 Median $63.10 Typical High $302.00 | Facility | 53 · Discontinued | $47.86 | $63.10 | $302.00 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $177.83 Median $239.88 Typical High $1,122.02 | Facility | 54 · Surgery only | $177.83 | $239.88 | $1,122.02 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $35.48 Median $47.86 Typical High $223.87 | Facility | 55 · Aftercare only | $35.48 | $47.86 | $223.87 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $23.99 Median $31.62 Typical High $151.36 | Facility | 56 · Pre-op care only | $23.99 | $31.62 | $151.36 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $117.49 Median $208.93 Typical High $812.83 | Professional | 52 · Reduced service | $117.49 | $208.93 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $85.11 Typical High $323.59 | Professional | 53 · Discontinued | $47.86 | $85.11 | $323.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $316.23 Typical High $1,202.26 | Professional | 54 · Surgery only | $177.83 | $316.23 | $1,202.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $63.10 Typical High $239.88 | Professional | 55 · Aftercare only | $35.48 | $63.10 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $41.69 Typical High $162.18 | Professional | 56 · Pre-op care only | $23.99 | $41.69 | $162.18 |
Where Kentucky sits
The same service costs 5.8 times more in Washington than in Hawaii. 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
$447
WA $1,820HI $316
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.