How much rates vary
Facilitymedian $100 · 10th to 90th $49 to $3,311Professionalmedian $91 · 10th to 90th $43 to $219
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 $48.98 Median $109.65 Typical High $794.33 | Facility | None | $48.98 | $109.65 | $794.33 |
Aetna Setting Professional Modifier None Typical Low $48.98 Median $109.65 Typical High $186.21 | Professional | None | $48.98 | $109.65 | $186.21 |
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 $40.74 Median $81.28 Typical High $141.25 | Professional | None | $40.74 | $81.28 | $141.25 |
CareSource Setting Facility Modifier None Typical Low $38.02 Median $45.71 Typical High $70.79 | Facility | None | $38.02 | $45.71 | $70.79 |
CareSource Setting Professional Modifier None Typical Low $40.74 Median $61.66 Typical High $74.13 | Professional | None | $40.74 | $61.66 | $74.13 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $74.13 Typical High $74.13 | Facility | None | $34.67 | $74.13 | $74.13 |
Cigna Setting Professional Modifier None Typical Low $44.67 Median $104.71 Typical High $602.56 | Professional | None | $44.67 | $104.71 | $602.56 |
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 $53.70 Median $114.82 Typical High $275.42 | Professional | None | $53.70 | $114.82 | $275.42 |
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 $24.55 Median $32.36 Typical High $74.13 | Facility | 52 · Reduced service | $24.55 | $32.36 | $74.13 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $9.77 Median $13.18 Typical High $29.51 | Facility | 53 · Discontinued | $9.77 | $13.18 | $29.51 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $36.31 Median $48.98 Typical High $109.65 | Facility | 54 · Surgery only | $36.31 | $48.98 | $109.65 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $7.41 Median $9.77 Typical High $21.88 | Facility | 55 · Aftercare only | $7.41 | $9.77 | $21.88 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $4.90 Median $6.46 Typical High $14.79 | Facility | 56 · Pre-op care only | $4.90 | $6.46 | $14.79 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $24.55 Median $42.66 Typical High $87.10 | Professional | 52 · Reduced service | $24.55 | $42.66 | $87.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.77 Median $16.98 Typical High $34.67 | Professional | 53 · Discontinued | $9.77 | $16.98 | $34.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $36.31 Median $64.57 Typical High $131.83 | Professional | 54 · Surgery only | $36.31 | $64.57 | $131.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.41 Median $12.88 Typical High $26.30 | Professional | 55 · Aftercare only | $7.41 | $12.88 | $26.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.90 Median $8.51 Typical High $17.38 | Professional | 56 · Pre-op care only | $4.90 | $8.51 | $17.38 |
Where Kentucky sits
The same service costs 2.8 times more in Wisconsin than in Florida. 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· 47th of 51
$91.20
WI $234FL $85.11
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.