How much rates vary
Facilitymedian $186 · 10th to 90th $78 to $1,479Professionalmedian $182 · 10th to 90th $72 to $417
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 $91.20 Median $234.42 Typical High $794.33 | Facility | None | $91.20 | $234.42 | $794.33 |
Aetna Setting Professional Modifier None Typical Low $91.20 Median $234.42 Typical High $371.54 | Professional | None | $91.20 | $234.42 | $371.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $758.58 Median $9,549.93 Typical High $11,220.18 | Facility | None | $758.58 | $9,549.93 | $11,220.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $72.44 Median $158.49 Typical High $275.42 | Professional | None | $72.44 | $158.49 | $275.42 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $109.65 Median $275.42 Typical High $416.87 | Professional | 50 · Both sides | $109.65 | $275.42 | $416.87 |
CareSource Setting Facility Modifier None Typical Low $69.18 Median $83.18 Typical High $131.83 | Facility | None | $69.18 | $83.18 | $131.83 |
CareSource Setting Professional Modifier None Typical Low $83.18 Median $114.82 Typical High $134.90 | Professional | None | $83.18 | $114.82 | $134.90 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $141.25 Typical High $691.83 | Facility | None | $34.67 | $141.25 | $691.83 |
Cigna Setting Professional Modifier None Typical Low $91.20 Median $309.03 Typical High $1,148.15 | Professional | None | $91.20 | $309.03 | $1,148.15 |
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 $70.79 Median $186.21 Typical High $1,148.15 | Facility | None | $70.79 | $186.21 | $1,148.15 |
United Setting Professional Modifier None Typical Low $123.03 Median $218.78 Typical High $489.78 | Professional | None | $123.03 | $218.78 | $489.78 |
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 $45.71 Median $63.10 Typical High $186.21 | Facility | 52 · Reduced service | $45.71 | $63.10 | $186.21 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $18.20 Median $25.70 Typical High $74.13 | Facility | 53 · Discontinued | $18.20 | $25.70 | $74.13 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $67.61 Median $95.50 Typical High $281.84 | Facility | 54 · Surgery only | $67.61 | $95.50 | $281.84 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $13.49 Median $19.05 Typical High $56.23 | Facility | 55 · Aftercare only | $13.49 | $19.05 | $56.23 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $9.12 Median $12.59 Typical High $37.15 | Facility | 56 · Pre-op care only | $9.12 | $12.59 | $37.15 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $45.71 Median $70.79 Typical High $186.21 | Professional | 52 · Reduced service | $45.71 | $70.79 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $28.84 Typical High $74.13 | Professional | 53 · Discontinued | $18.20 | $28.84 | $74.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $67.61 Median $107.15 Typical High $281.84 | Professional | 54 · Surgery only | $67.61 | $107.15 | $281.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $21.38 Typical High $56.23 | Professional | 55 · Aftercare only | $13.49 | $21.38 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $14.45 Typical High $37.15 | Professional | 56 · Pre-op care only | $9.12 | $14.45 | $37.15 |
Where Kentucky sits
The same service costs 3.6 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· 48th of 51
$182
WI $537NE $148
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.