How much rates vary
Facilitymedian $1,072 · 10th to 90th $257 to $7,762Professionalmedian $977 · 10th to 90th $229 to $2,188
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 $257.04 Median $851.14 Typical High $2,137.96 | Facility | None | $257.04 | $851.14 | $2,137.96 |
Aetna Setting Professional Modifier None Typical Low $257.04 Median $1,148.15 Typical High $1,862.09 | Professional | None | $257.04 | $1,148.15 | $1,862.09 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,888.44 Median $9,120.11 Typical High $11,220.18 | Facility | None | $5,888.44 | $9,120.11 | $11,220.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $223.87 Median $891.25 Typical High $1,621.81 | Professional | None | $223.87 | $891.25 | $1,621.81 |
CareSource Setting Facility Modifier None Typical Low $199.53 Median $239.88 Typical High $371.54 | Facility | None | $199.53 | $239.88 | $371.54 |
CareSource Setting Professional Modifier None Typical Low $213.80 Median $316.23 Typical High $380.19 | Professional | None | $213.80 | $316.23 | $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 $1,122.02 Typical High $6,309.57 | Professional | None | $239.88 | $1,122.02 | $6,309.57 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $234.42 | Professional | None | $33.11 | $33.11 | $234.42 |
United Setting Facility Modifier None Typical Low $741.31 Median $4,073.80 Typical High $8,511.38 | Facility | None | $741.31 | $4,073.80 | $8,511.38 |
United Setting Professional Modifier None Typical Low $309.03 Median $1,288.25 Typical High $2,570.40 | Professional | None | $309.03 | $1,288.25 | $2,570.40 |
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 $128.82 Median $194.98 Typical High $954.99 | Facility | 52 · Reduced service | $128.82 | $194.98 | $954.99 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $51.29 Median $79.43 Typical High $389.05 | Facility | 53 · Discontinued | $51.29 | $79.43 | $389.05 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $190.55 Median $295.12 Typical High $1,445.44 | Facility | 54 · Surgery only | $190.55 | $295.12 | $1,445.44 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $38.02 Median $58.88 Typical High $288.40 | Facility | 55 · Aftercare only | $38.02 | $58.88 | $288.40 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $25.70 Median $38.90 Typical High $190.55 | Facility | 56 · Pre-op care only | $25.70 | $38.90 | $190.55 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $128.82 Median $549.54 Typical High $912.01 | Professional | 52 · Reduced service | $128.82 | $549.54 | $912.01 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $218.78 Typical High $371.54 | Professional | 53 · Discontinued | $51.29 | $218.78 | $371.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $190.55 Median $812.83 Typical High $1,380.38 | Professional | 54 · Surgery only | $190.55 | $812.83 | $1,380.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $162.18 Typical High $275.42 | Professional | 55 · Aftercare only | $38.02 | $162.18 | $275.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $109.65 Typical High $186.21 | Professional | 56 · Pre-op care only | $25.70 | $109.65 | $186.21 |
Where Kentucky sits
The same service costs 4.7 times more in Wisconsin than in Nebraska. 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· 43rd of 51
$977
WI $2,089NE $447
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.