How much rates vary
Facilitymedian $1,148 · 10th to 90th $251 to $2,818Professionalmedian $251 · 10th to 90th $132 to $479
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 $154.88 Median $380.19 Typical High $851.14 | Facility | None | $154.88 | $380.19 | $851.14 |
Aetna Setting Professional Modifier None Typical Low $154.88 Median $223.87 Typical High $478.63 | Professional | None | $154.88 | $223.87 | $478.63 |
Anthem BCBS Setting Facility Modifier None Typical Low $602.56 Median $1,698.24 Typical High $2,884.03 | Facility | None | $602.56 | $1,698.24 | $2,884.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $131.83 Median $229.09 Typical High $316.23 | Professional | None | $131.83 | $229.09 | $316.23 |
CareSource Setting Facility Modifier None Typical Low $144.54 Median $234.42 Typical High $1,445.44 | Facility | None | $144.54 | $234.42 | $1,445.44 |
CareSource Setting Professional Modifier None Typical Low $131.83 Median $181.97 Typical High $234.42 | Professional | None | $131.83 | $181.97 | $234.42 |
Cigna Setting Facility Modifier None Typical Low $251.19 Median $1,023.29 Typical High $1,318.26 | Facility | None | $251.19 | $1,023.29 | $1,318.26 |
Cigna Setting Professional Modifier None Typical Low $151.36 Median $380.19 Typical High $2,238.72 | Professional | None | $151.36 | $380.19 | $2,238.72 |
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 $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 $316.23 Typical High $524.81 | Professional | None | $177.83 | $316.23 | $524.81 |
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 $77.62 Median $97.72 Typical High $239.88 | Facility | 52 · Reduced service | $77.62 | $97.72 | $239.88 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $30.90 Median $38.90 Typical High $95.50 | Facility | 53 · Discontinued | $30.90 | $38.90 | $95.50 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $114.82 Median $144.54 Typical High $363.08 | Facility | 54 · Surgery only | $114.82 | $144.54 | $363.08 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $22.91 Median $29.51 Typical High $72.44 | Facility | 55 · Aftercare only | $22.91 | $29.51 | $72.44 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $15.49 Median $19.50 Typical High $47.86 | Facility | 56 · Pre-op care only | $15.49 | $19.50 | $47.86 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $77.62 Median $109.65 Typical High $239.88 | Professional | 52 · Reduced service | $77.62 | $109.65 | $239.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $43.65 Typical High $95.50 | Professional | 53 · Discontinued | $30.90 | $43.65 | $95.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $165.96 Typical High $363.08 | Professional | 54 · Surgery only | $114.82 | $165.96 | $363.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $33.11 Typical High $72.44 | Professional | 55 · Aftercare only | $22.91 | $33.11 | $72.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $21.88 Typical High $47.86 | Professional | 56 · Pre-op care only | $15.49 | $21.88 | $47.86 |
Where Kentucky sits
The same service costs 4.5 times more in Alaska than in Washington, DC. 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· 48th of 51
$257
AK $851DC $191
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.