How much rates vary
Facilitymedian $427 · 10th to 90th $83 to $2,512Professionalmedian $229 · 10th to 90th $72 to $631
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 $83.18 Median $346.74 Typical High $794.33 | Facility | None | $83.18 | $346.74 | $794.33 |
Aetna Setting Professional Modifier None Typical Low $83.18 Median $346.74 Typical High $575.44 | Professional | None | $83.18 | $346.74 | $575.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $575.44 Median $3,801.89 Typical High $11,220.18 | Facility | None | $575.44 | $3,801.89 | $11,220.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $67.61 Median $229.09 Typical High $363.08 | Professional | None | $67.61 | $229.09 | $363.08 |
CareSource Setting Facility Modifier None Typical Low $72.44 Median $120.23 Typical High $562.34 | Facility | None | $72.44 | $120.23 | $562.34 |
CareSource Setting Professional Modifier None Typical Low $81.28 Median $104.71 Typical High $125.89 | Professional | None | $81.28 | $104.71 | $125.89 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $363.08 Typical High $691.83 | Facility | None | $34.67 | $363.08 | $691.83 |
Cigna Setting Professional Modifier None Typical Low $79.43 Median $407.38 Typical High $1,778.28 | Professional | None | $79.43 | $407.38 | $1,778.28 |
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 $128.82 Median $323.59 Typical High $724.44 | Professional | None | $128.82 | $323.59 | $724.44 |
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 $41.69 Median $67.61 Typical High $281.84 | Facility | 52 · Reduced service | $41.69 | $67.61 | $281.84 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $16.60 Median $26.92 Typical High $114.82 | Facility | 53 · Discontinued | $16.60 | $26.92 | $114.82 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $61.66 Median $102.33 Typical High $426.58 | Facility | 54 · Surgery only | $61.66 | $102.33 | $426.58 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $12.59 Median $20.42 Typical High $85.11 | Facility | 55 · Aftercare only | $12.59 | $20.42 | $85.11 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $8.32 Median $13.49 Typical High $57.54 | Facility | 56 · Pre-op care only | $8.32 | $13.49 | $57.54 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $41.69 Median $67.61 Typical High $275.42 | Professional | 52 · Reduced service | $41.69 | $67.61 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $26.92 Typical High $109.65 | Professional | 53 · Discontinued | $16.60 | $26.92 | $109.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $61.66 Median $102.33 Typical High $416.87 | Professional | 54 · Surgery only | $61.66 | $102.33 | $416.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $20.42 Typical High $83.18 | Professional | 55 · Aftercare only | $12.59 | $20.42 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $13.49 Typical High $54.95 | Professional | 56 · Pre-op care only | $8.32 | $13.49 | $54.95 |
Where Kentucky sits
The same service costs 7.8 times more in Oklahoma 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
$263
OK $1,148NE $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.