How much rates vary
Facilitymedian $871 · 10th to 90th $155 to $3,981Professionalmedian $1,122 · 10th to 90th $126 to $2,455
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 $154.88 Median $851.14 Typical High $2,238.72 | Facility | None | $154.88 | $851.14 | $2,238.72 |
Aetna Setting Professional Modifier None Typical Low $154.88 Median $1,202.26 Typical High $2,238.72 | Professional | None | $154.88 | $1,202.26 | $2,238.72 |
Ambetter Setting Professional Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $1,202.26 | Professional | None | $1,202.26 | $1,202.26 | $1,202.26 |
Anthem BCBS Setting Facility Modifier None Typical Low $758.58 Median $5,011.87 Typical High $11,220.18 | Facility | None | $758.58 | $5,011.87 | $11,220.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $125.89 Median $1,096.48 Typical High $1,659.59 | Professional | None | $125.89 | $1,096.48 | $1,659.59 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $190.55 Median $1,621.81 Typical High $2,511.89 | Professional | 50 · Both sides | $190.55 | $1,621.81 | $2,511.89 |
CareSource Setting Facility Modifier None Typical Low $131.83 Median $223.87 Typical High $1,659.59 | Facility | None | $131.83 | $223.87 | $1,659.59 |
CareSource Setting Professional Modifier None Typical Low $138.04 Median $194.98 Typical High $229.09 | Professional | None | $138.04 | $194.98 | $229.09 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $831.76 Typical High $1,348.96 | Facility | None | $34.67 | $831.76 | $1,348.96 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $1,348.96 Typical High $6,456.54 | Professional | None | $158.49 | $1,348.96 | $6,456.54 |
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 $457.09 Median $794.33 Typical High $2,454.71 | Facility | None | $457.09 | $794.33 | $2,454.71 |
United Setting Professional Modifier None Typical Low $213.80 Median $1,288.25 Typical High $2,818.38 | Professional | None | $213.80 | $1,288.25 | $2,818.38 |
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 $75.86 Median $109.65 Typical High $1,122.02 | Facility | 52 · Reduced service | $75.86 | $109.65 | $1,122.02 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $30.90 Median $43.65 Typical High $446.68 | Facility | 53 · Discontinued | $30.90 | $43.65 | $446.68 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $114.82 Median $165.96 Typical High $1,659.59 | Facility | 54 · Surgery only | $114.82 | $165.96 | $1,659.59 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $22.91 Median $33.11 Typical High $331.13 | Facility | 55 · Aftercare only | $22.91 | $33.11 | $331.13 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $15.49 Median $21.88 Typical High $223.87 | Facility | 56 · Pre-op care only | $15.49 | $21.88 | $223.87 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $75.86 Median $120.23 Typical High $954.99 | Professional | 52 · Reduced service | $75.86 | $120.23 | $954.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $48.98 Typical High $380.19 | Professional | 53 · Discontinued | $30.90 | $48.98 | $380.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $181.97 Typical High $1,445.44 | Professional | 54 · Surgery only | $114.82 | $181.97 | $1,445.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $36.31 Typical High $288.40 | Professional | 55 · Aftercare only | $22.91 | $36.31 | $288.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $23.99 Typical High $190.55 | Professional | 56 · Pre-op care only | $15.49 | $23.99 | $190.55 |
Where Kentucky sits
The same service costs 8.5 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
$1,096
WI $2,291NE $269
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.