How much rates vary
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 $53.70 Median $81.28 Typical High $112.20 | Facility | None | $53.70 | $81.28 | $112.20 |
Aetna Setting Professional Modifier None Typical Low $53.70 Median $85.11 Typical High $128.82 | Professional | None | $53.70 | $85.11 | $128.82 |
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 $43.65 Median $74.13 Typical High $107.15 | Professional | None | $43.65 | $74.13 | $107.15 |
CareSource Setting Facility Modifier None Typical Low $47.86 Median $524.81 Typical High $933.25 | Facility | None | $47.86 | $524.81 | $933.25 |
CareSource Setting Professional Modifier None Typical Low $47.86 Median $67.61 Typical High $79.43 | Professional | None | $47.86 | $67.61 | $79.43 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $81.28 Typical High $81.28 | Facility | None | $34.67 | $81.28 | $81.28 |
Cigna Setting Professional Modifier None Typical Low $60.26 Median $120.23 Typical High $426.58 | Professional | None | $60.26 | $120.23 | $426.58 |
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 $75.86 Median $109.65 Typical High $190.55 | Professional | None | $75.86 | $109.65 | $190.55 |
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 $26.92 Median $40.74 Typical High $56.23 | Facility | 52 · Reduced service | $26.92 | $40.74 | $56.23 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $10.72 Median $16.22 Typical High $22.91 | Facility | 53 · Discontinued | $10.72 | $16.22 | $22.91 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $39.81 Median $61.66 Typical High $85.11 | Facility | 54 · Surgery only | $39.81 | $61.66 | $85.11 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $7.94 Median $12.30 Typical High $16.98 | Facility | 55 · Aftercare only | $7.94 | $12.30 | $16.98 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $5.37 Median $8.13 Typical High $11.22 | Facility | 56 · Pre-op care only | $5.37 | $8.13 | $11.22 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $26.92 Median $41.69 Typical High $64.57 | Professional | 52 · Reduced service | $26.92 | $41.69 | $64.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.72 Median $16.98 Typical High $25.70 | Professional | 53 · Discontinued | $10.72 | $16.98 | $25.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $39.81 Median $63.10 Typical High $97.72 | Professional | 54 · Surgery only | $39.81 | $63.10 | $97.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.94 Median $12.59 Typical High $19.50 | Professional | 55 · Aftercare only | $7.94 | $12.59 | $19.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.37 Median $8.51 Typical High $12.88 | Professional | 56 · Pre-op care only | $5.37 | $8.51 | $12.88 |
Where Kentucky sits
The same service costs 3.7 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· 49th of 51
$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.