How much rates vary
Facilitymedian $1,175 · 10th to 90th $229 to $3,890Professionalmedian $389 · 10th to 90th $138 to $912
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 $169.82 Median $645.65 Typical High $1,047.13 | Facility | None | $169.82 | $645.65 | $1,047.13 |
Aetna Setting Professional Modifier None Typical Low $154.88 Median $489.78 Typical High $977.24 | Professional | None | $154.88 | $489.78 | $977.24 |
Ambetter Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $144.54 | Professional | None | $128.82 | $128.82 | $144.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $724.44 Median $1,995.26 Typical High $4,265.80 | Facility | None | $724.44 | $1,995.26 | $4,265.80 |
Anthem BCBS Setting Professional Modifier None Typical Low $123.03 Median $331.13 Typical High $630.96 | Professional | None | $123.03 | $331.13 | $630.96 |
CareSource Setting Facility Modifier None Typical Low $131.83 Median $245.47 Typical High $891.25 | Facility | None | $131.83 | $245.47 | $891.25 |
CareSource Setting Professional Modifier None Typical Low $169.82 Median $213.80 Typical High $257.04 | Professional | None | $169.82 | $213.80 | $257.04 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $616.60 Typical High $691.83 | Facility | None | $34.67 | $616.60 | $691.83 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $616.60 Typical High $3,311.31 | Professional | None | $158.49 | $616.60 | $3,311.31 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $123.03 | Professional | None | $33.11 | $33.11 | $123.03 |
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 $177.83 Median $562.34 Typical High $977.24 | Professional | None | $177.83 | $562.34 | $977.24 |
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 $85.11 Median $112.20 Typical High $436.52 | Facility | 52 · Reduced service | $85.11 | $112.20 | $436.52 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $33.88 Median $45.71 Typical High $173.78 | Facility | 53 · Discontinued | $33.88 | $45.71 | $173.78 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $125.89 Median $169.82 Typical High $645.65 | Facility | 54 · Surgery only | $125.89 | $169.82 | $645.65 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $25.70 Median $33.88 Typical High $128.82 | Facility | 55 · Aftercare only | $25.70 | $33.88 | $128.82 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $16.98 Median $22.91 Typical High $87.10 | Facility | 56 · Pre-op care only | $16.98 | $22.91 | $87.10 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $85.11 Median $239.88 Typical High $436.52 | Professional | 52 · Reduced service | $85.11 | $239.88 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $95.50 Typical High $173.78 | Professional | 53 · Discontinued | $33.88 | $95.50 | $173.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $125.89 Median $354.81 Typical High $645.65 | Professional | 54 · Surgery only | $125.89 | $354.81 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $70.79 Typical High $128.82 | Professional | 55 · Aftercare only | $25.70 | $70.79 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $47.86 Typical High $89.13 | Professional | 56 · Pre-op care only | $16.98 | $47.86 | $89.13 |
Where Kentucky sits
The same service costs 5.2 times more in Wisconsin than in Hawaii. 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· 47th of 51
$447
WI $1,148HI $219
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.