How much rates vary
Facilitymedian $417 · 10th to 90th $100 to $3,311Professionalmedian $490 · 10th to 90th $224 to $1,479
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 $251.19 Median $562.34 Typical High $1,621.81 | Facility | None | $251.19 | $562.34 | $1,621.81 |
Aetna Setting Professional Modifier None Typical Low $251.19 Median $691.83 Typical High $1,412.54 | Professional | None | $251.19 | $691.83 | $1,412.54 |
Ambetter Setting Professional Modifier None Typical Low $186.21 Median $251.19 Typical High $251.19 | Professional | None | $186.21 | $251.19 | $251.19 |
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 $213.80 Median $416.87 Typical High $1,000.00 | Professional | None | $213.80 | $416.87 | $1,000.00 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $323.59 Median $630.96 Typical High $1,479.11 | Professional | 50 · Both sides | $323.59 | $630.96 | $1,479.11 |
CareSource Setting Facility Modifier None Typical Low $194.98 Median $234.42 Typical High $371.54 | Facility | None | $194.98 | $234.42 | $371.54 |
CareSource Setting Professional Modifier None Typical Low $251.19 Median $323.59 Typical High $380.19 | Professional | None | $251.19 | $323.59 | $380.19 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $398.11 Typical High $398.11 | Facility | None | $34.67 | $398.11 | $398.11 |
Cigna Setting Professional Modifier None Typical Low $239.88 Median $741.31 Typical High $4,466.84 | Professional | None | $239.88 | $741.31 | $4,466.84 |
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 $281.84 Median $645.65 Typical High $2,089.30 | Professional | None | $281.84 | $645.65 | $2,089.30 |
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 $125.89 Median $169.82 Typical High $512.86 | Facility | 52 · Reduced service | $125.89 | $169.82 | $512.86 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $51.29 Median $67.61 Typical High $204.17 | Facility | 53 · Discontinued | $51.29 | $67.61 | $204.17 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $190.55 Median $257.04 Typical High $776.25 | Facility | 54 · Surgery only | $190.55 | $257.04 | $776.25 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $38.02 Median $51.29 Typical High $154.88 | Facility | 55 · Aftercare only | $38.02 | $51.29 | $154.88 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $25.12 Median $33.88 Typical High $102.33 | Facility | 56 · Pre-op care only | $25.12 | $33.88 | $102.33 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $125.89 Median $229.09 Typical High $602.56 | Professional | 52 · Reduced service | $125.89 | $229.09 | $602.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $91.20 Typical High $239.88 | Professional | 53 · Discontinued | $51.29 | $91.20 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $190.55 Median $338.84 Typical High $912.01 | Professional | 54 · Surgery only | $190.55 | $338.84 | $912.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $67.61 Typical High $181.97 | Professional | 55 · Aftercare only | $38.02 | $67.61 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $45.71 Typical High $120.23 | Professional | 56 · Pre-op care only | $25.12 | $45.71 | $120.23 |
Where Kentucky sits
The same service costs 4.3 times more in Wisconsin 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
$490
WI $1,380HI $324
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.