How much rates vary
Facilitymedian $257 · 10th to 90th $79 to $3,388Professionalmedian $135 · 10th to 90th $66 to $245
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 $79.43 Median $177.83 Typical High $794.33 | Facility | None | $79.43 | $177.83 | $794.33 |
Aetna Setting Professional Modifier None Typical Low $79.43 Median $162.18 Typical High $223.87 | Professional | None | $79.43 | $162.18 | $223.87 |
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 $61.66 Median $120.23 Typical High $181.97 | Professional | None | $61.66 | $120.23 | $181.97 |
CareSource Setting Facility Modifier None Typical Low $74.13 Median $120.23 Typical High $218.78 | Facility | None | $74.13 | $120.23 | $218.78 |
CareSource Setting Professional Modifier None Typical Low $74.13 Median $91.20 Typical High $120.23 | Professional | None | $74.13 | $91.20 | $120.23 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $154.88 Typical High $831.76 | Facility | None | $34.67 | $154.88 | $831.76 |
Cigna Setting Professional Modifier None Typical Low $77.62 Median $173.78 Typical High $954.99 | Professional | None | $77.62 | $173.78 | $954.99 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $50.12 | Professional | None | $33.11 | $33.11 | $50.12 |
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 $91.20 Median $158.49 Typical High $288.40 | Professional | None | $91.20 | $158.49 | $288.40 |
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 $39.81 Median $60.26 Typical High $128.82 | Facility | 52 · Reduced service | $39.81 | $60.26 | $128.82 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $15.85 Median $23.99 Typical High $52.48 | Facility | 53 · Discontinued | $15.85 | $23.99 | $52.48 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $60.26 Median $89.13 Typical High $194.98 | Facility | 54 · Surgery only | $60.26 | $89.13 | $194.98 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $12.02 Median $18.20 Typical High $38.90 | Facility | 55 · Aftercare only | $12.02 | $18.20 | $38.90 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $7.94 Median $12.02 Typical High $25.70 | Facility | 56 · Pre-op care only | $7.94 | $12.02 | $25.70 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $39.81 Median $77.62 Typical High $112.20 | Professional | 52 · Reduced service | $39.81 | $77.62 | $112.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.85 Median $30.90 Typical High $45.71 | Professional | 53 · Discontinued | $15.85 | $30.90 | $45.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $60.26 Median $114.82 Typical High $169.82 | Professional | 54 · Surgery only | $60.26 | $114.82 | $169.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $22.91 Typical High $33.88 | Professional | 55 · Aftercare only | $12.02 | $22.91 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $15.49 Typical High $22.39 | Professional | 56 · Pre-op care only | $7.94 | $15.49 | $22.39 |
Where Kentucky sits
The same service costs 3.7 times more in Alaska than in Maryland. 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
$135
AK $355MD $95.50
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.