How much rates vary
Facilitymedian $1,175 · 10th to 90th $174 to $2,818Professionalmedian $195 · 10th to 90th $110 to $468
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 $87.10 Median $181.97 Typical High $794.33 | Facility | None | $87.10 | $181.97 | $794.33 |
Aetna Setting Professional Modifier None Typical Low $87.10 Median $181.97 Typical High $288.40 | Professional | None | $87.10 | $181.97 | $288.40 |
Anthem BCBS Setting Facility Modifier None Typical Low $602.56 Median $1,698.24 Typical High $2,884.03 | Facility | None | $602.56 | $1,698.24 | $2,884.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $112.20 Median $194.98 Typical High $446.68 | Professional | None | $112.20 | $194.98 | $446.68 |
CareSource Setting Facility Modifier None Typical Low $77.62 Median $125.89 Typical High $2,691.53 | Facility | None | $77.62 | $125.89 | $2,691.53 |
CareSource Setting Professional Modifier None Typical Low $70.79 Median $109.65 Typical High $128.82 | Professional | None | $70.79 | $109.65 | $128.82 |
Cigna Setting Facility Modifier None Typical Low $141.25 Median $1,318.26 Typical High $1,949.84 | Facility | None | $141.25 | $1,318.26 | $1,949.84 |
Cigna Setting Professional Modifier None Typical Low $95.50 Median $269.15 Typical High $1,995.26 | Professional | None | $95.50 | $269.15 | $1,995.26 |
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 $323.59 Median $588.84 Typical High $1,621.81 | Facility | None | $323.59 | $588.84 | $1,621.81 |
United Setting Professional Modifier None Typical Low $147.91 Median $223.87 Typical High $457.09 | Professional | None | $147.91 | $223.87 | $457.09 |
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 $43.65 Median $87.10 Typical High $194.98 | Facility | 52 · Reduced service | $43.65 | $87.10 | $194.98 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $17.38 Median $34.67 Typical High $77.62 | Facility | 53 · Discontinued | $17.38 | $34.67 | $77.62 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $64.57 Median $128.82 Typical High $295.12 | Facility | 54 · Surgery only | $64.57 | $128.82 | $295.12 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $12.88 Median $26.30 Typical High $58.88 | Facility | 55 · Aftercare only | $12.88 | $26.30 | $58.88 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $8.71 Median $17.38 Typical High $38.90 | Facility | 56 · Pre-op care only | $8.71 | $17.38 | $38.90 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $43.65 Median $91.20 Typical High $144.54 | Professional | 52 · Reduced service | $43.65 | $91.20 | $144.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.38 Median $36.31 Typical High $57.54 | Professional | 53 · Discontinued | $17.38 | $36.31 | $57.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $64.57 Median $134.90 Typical High $213.80 | Professional | 54 · Surgery only | $64.57 | $134.90 | $213.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $26.92 Typical High $42.66 | Professional | 55 · Aftercare only | $12.88 | $26.92 | $42.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $18.20 Typical High $28.84 | Professional | 56 · Pre-op care only | $8.71 | $18.20 | $28.84 |
Where Kentucky sits
The same service costs 4.1 times more in Alaska 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· 44th of 51
$224
AK $646NE $158
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.