How much rates vary
Facilitymedian $166 · 10th to 90th $66 to $1,950Professionalmedian $155 · 10th to 90th $65 to $295
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 $70.79 Median $165.96 Typical High $416.87 | Facility | None | $70.79 | $165.96 | $416.87 |
Aetna Setting Professional Modifier None Typical Low $70.79 Median $165.96 Typical High $263.03 | Professional | None | $70.79 | $165.96 | $263.03 |
Ambetter Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $154.88 | Professional | None | $154.88 | $154.88 | $154.88 |
Anthem BCBS Setting Facility Modifier None Typical Low $9,120.11 Median $10,715.19 Typical High $11,220.18 | Facility | None | $9,120.11 | $10,715.19 | $11,220.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $63.10 Median $154.88 Typical High $204.17 | Professional | None | $63.10 | $154.88 | $204.17 |
CareSource Setting Facility Modifier None Typical Low $54.95 Median $66.07 Typical High $104.71 | Facility | None | $54.95 | $66.07 | $104.71 |
CareSource Setting Professional Modifier None Typical Low $63.10 Median $87.10 Typical High $104.71 | Professional | None | $63.10 | $87.10 | $104.71 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $112.20 Typical High $112.20 | Facility | None | $34.67 | $112.20 | $112.20 |
Cigna Setting Professional Modifier None Typical Low $66.07 Median $154.88 Typical High $851.14 | Professional | None | $66.07 | $154.88 | $851.14 |
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 $50.12 Median $416.87 Typical High $1,949.84 | Facility | None | $50.12 | $416.87 | $1,949.84 |
United Setting Professional Modifier None Typical Low $91.20 Median $177.83 Typical High $371.54 | Professional | None | $91.20 | $177.83 | $371.54 |
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 $35.48 Median $53.70 Typical High $147.91 | Facility | 52 · Reduced service | $35.48 | $53.70 | $147.91 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $14.45 Median $21.88 Typical High $58.88 | Facility | 53 · Discontinued | $14.45 | $21.88 | $58.88 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $53.70 Median $81.28 Typical High $218.78 | Facility | 54 · Surgery only | $53.70 | $81.28 | $218.78 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $10.72 Median $16.22 Typical High $44.67 | Facility | 55 · Aftercare only | $10.72 | $16.22 | $44.67 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $7.08 Median $10.72 Typical High $29.51 | Facility | 56 · Pre-op care only | $7.08 | $10.72 | $29.51 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $35.48 Median $83.18 Typical High $109.65 | Professional | 52 · Reduced service | $35.48 | $83.18 | $109.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.45 Median $33.11 Typical High $43.65 | Professional | 53 · Discontinued | $14.45 | $33.11 | $43.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $53.70 Median $123.03 Typical High $165.96 | Professional | 54 · Surgery only | $53.70 | $123.03 | $165.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.72 Median $24.55 Typical High $33.11 | Professional | 55 · Aftercare only | $10.72 | $24.55 | $33.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.08 Median $16.60 Typical High $21.88 | Professional | 56 · Pre-op care only | $7.08 | $16.60 | $21.88 |
Where Kentucky sits
The same service costs 2.7 times more in Wisconsin than in Utah. 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· 43rd of 51
$155
WI $316UT $117
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.