How much rates vary
Facilitymedian $251 · 10th to 90th $89 to $1,479Professionalmedian $479 · 10th to 90th $115 to $1,047
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 $147.91 Median $537.03 Typical High $977.24 | Facility | None | $147.91 | $537.03 | $977.24 |
Aetna Setting Professional Modifier None Typical Low $131.83 Median $537.03 Typical High $977.24 | Professional | None | $131.83 | $537.03 | $977.24 |
Ambetter Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
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 $104.71 Median $478.63 Typical High $724.44 | Professional | None | $104.71 | $478.63 | $724.44 |
CareSource Setting Facility Modifier None Typical Low $114.82 Median $138.04 Typical High $213.80 | Facility | None | $114.82 | $138.04 | $213.80 |
CareSource Setting Professional Modifier None Typical Low $134.90 Median $186.21 Typical High $223.87 | Professional | None | $134.90 | $186.21 | $223.87 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $229.09 Typical High $691.83 | Facility | None | $34.67 | $229.09 | $691.83 |
Cigna Setting Professional Modifier None Typical Low $138.04 Median $645.65 Typical High $2,818.38 | Professional | None | $138.04 | $645.65 | $2,818.38 |
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 $177.83 Median $549.54 Typical High $1,230.27 | Professional | None | $177.83 | $549.54 | $1,230.27 |
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 $74.13 Median $97.72 Typical High $489.78 | Facility | 52 · Reduced service | $74.13 | $97.72 | $489.78 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $29.51 Median $39.81 Typical High $194.98 | Facility | 53 · Discontinued | $29.51 | $39.81 | $194.98 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $112.20 Median $147.91 Typical High $724.44 | Facility | 54 · Surgery only | $112.20 | $147.91 | $724.44 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $22.39 Median $29.51 Typical High $144.54 | Facility | 55 · Aftercare only | $22.39 | $29.51 | $144.54 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $14.79 Median $19.95 Typical High $97.72 | Facility | 56 · Pre-op care only | $14.79 | $19.95 | $97.72 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $74.13 Median $117.49 Typical High $426.58 | Professional | 52 · Reduced service | $74.13 | $117.49 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $29.51 Median $46.77 Typical High $169.82 | Professional | 53 · Discontinued | $29.51 | $46.77 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $112.20 Median $173.78 Typical High $645.65 | Professional | 54 · Surgery only | $112.20 | $173.78 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $35.48 Typical High $128.82 | Professional | 55 · Aftercare only | $22.39 | $35.48 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.79 Median $23.44 Typical High $85.11 | Professional | 56 · Pre-op care only | $14.79 | $23.44 | $85.11 |
Where Kentucky sits
The same service costs 17.4 times more in Alabama than in Montana. 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.
Physician feeFacility fee
AL $9,157MT $526
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.