How much rates vary
Facilitymedian $3,236 · 10th to 90th $427 to $10,965Professionalmedian $3,090 · 10th to 90th $372 to $6,918
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 $426.58 Median $912.01 Typical High $6,760.83 | Facility | None | $426.58 | $912.01 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $426.58 Median $1,819.70 Typical High $6,025.60 | Professional | None | $426.58 | $1,819.70 | $6,025.60 |
Ambetter Setting Professional Modifier None Typical Low $3,981.07 Median $3,981.07 Typical High $3,981.07 | Professional | None | $3,981.07 | $3,981.07 | $3,981.07 |
Anthem BCBS Setting Facility Modifier None Typical Low $758.58 Median $5,888.44 Typical High $11,220.18 | Facility | None | $758.58 | $5,888.44 | $11,220.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $346.74 Median $2,884.03 Typical High $4,786.30 | Professional | None | $346.74 | $2,884.03 | $4,786.30 |
CareSource Setting Facility Modifier None Typical Low $331.13 Median $630.96 Typical High $10,964.78 | Facility | None | $331.13 | $630.96 | $10,964.78 |
CareSource Setting Professional Modifier None Typical Low $426.58 Median $549.54 Typical High $645.65 | Professional | None | $426.58 | $549.54 | $645.65 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $794.33 Typical High $8,128.31 | Facility | None | $34.67 | $794.33 | $8,128.31 |
Cigna Setting Professional Modifier None Typical Low $407.38 Median $4,466.84 Typical High $21,379.62 | Professional | None | $407.38 | $4,466.84 | $21,379.62 |
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 $1,148.15 Median $3,162.28 Typical High $12,022.64 | Facility | None | $1,148.15 | $3,162.28 | $12,022.64 |
United Setting Professional Modifier None Typical Low $630.96 Median $3,548.13 Typical High $8,128.31 | Professional | None | $630.96 | $3,548.13 | $8,128.31 |
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 $213.80 Median $323.59 Typical High $3,019.95 | Facility | 52 · Reduced service | $213.80 | $323.59 | $3,019.95 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $85.11 Median $131.83 Typical High $1,202.26 | Facility | 53 · Discontinued | $85.11 | $131.83 | $1,202.26 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $323.59 Median $489.78 Typical High $4,570.88 | Facility | 54 · Surgery only | $323.59 | $489.78 | $4,570.88 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $64.57 Median $97.72 Typical High $912.01 | Facility | 55 · Aftercare only | $64.57 | $97.72 | $912.01 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $42.66 Median $66.07 Typical High $602.56 | Facility | 56 · Pre-op care only | $42.66 | $66.07 | $602.56 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $213.80 Median $338.84 Typical High $3,019.95 | Professional | 52 · Reduced service | $213.80 | $338.84 | $3,019.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $85.11 Median $134.90 Typical High $1,202.26 | Professional | 53 · Discontinued | $85.11 | $134.90 | $1,202.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $323.59 Median $512.86 Typical High $4,570.88 | Professional | 54 · Surgery only | $323.59 | $512.86 | $4,570.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $102.33 Typical High $912.01 | Professional | 55 · Aftercare only | $64.57 | $102.33 | $912.01 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $67.61 Typical High $602.56 | Professional | 56 · Pre-op care only | $42.66 | $67.61 | $602.56 |
Where Kentucky sits
The same service costs 4.3 times more in Alabama than in Maine. 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 $20,420ME $4,758
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.