How much rates vary
Facilitymedian $871 · 10th to 90th $74 to $2,818Professionalmedian $68 · 10th to 90th $36 to $135
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 $46.77 Median $120.23 Typical High $851.14 | Facility | None | $46.77 | $120.23 | $851.14 |
Aetna Setting Professional Modifier None Typical Low $46.77 Median $100.00 Typical High $151.36 | Professional | None | $46.77 | $100.00 | $151.36 |
Ambetter Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $123.03 | Professional | None | $104.71 | $104.71 | $123.03 |
Anthem BCBS Setting Facility Modifier None Typical Low $588.84 Median $1,698.24 Typical High $2,884.03 | Facility | None | $588.84 | $1,698.24 | $2,884.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $36.31 Median $53.70 Typical High $102.33 | Professional | None | $36.31 | $53.70 | $102.33 |
CareSource Setting Facility Modifier None Typical Low $43.65 Median $70.79 Typical High $162.18 | Facility | None | $43.65 | $70.79 | $162.18 |
CareSource Setting Professional Modifier None Typical Low $43.65 Median $56.23 Typical High $74.13 | Professional | None | $43.65 | $56.23 | $74.13 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $128.82 Typical High $398.11 | Facility | None | $34.67 | $128.82 | $398.11 |
Cigna Setting Professional Modifier None Typical Low $45.71 Median $114.82 Typical High $724.44 | Professional | None | $45.71 | $114.82 | $724.44 |
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 $323.59 Median $588.84 Typical High $1,621.81 | Facility | None | $323.59 | $588.84 | $1,621.81 |
United Setting Professional Modifier None Typical Low $45.71 Median $87.10 Typical High $144.54 | Professional | None | $45.71 | $87.10 | $144.54 |
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 $23.44 Median $37.15 Typical High $75.86 | Facility | 52 · Reduced service | $23.44 | $37.15 | $75.86 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $9.33 Median $14.79 Typical High $30.20 | Facility | 53 · Discontinued | $9.33 | $14.79 | $30.20 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $35.48 Median $54.95 Typical High $112.20 | Facility | 54 · Surgery only | $35.48 | $54.95 | $112.20 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $7.08 Median $11.22 Typical High $22.39 | Facility | 55 · Aftercare only | $7.08 | $11.22 | $22.39 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $4.68 Median $7.41 Typical High $15.14 | Facility | 56 · Pre-op care only | $4.68 | $7.41 | $15.14 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $23.44 Median $37.15 Typical High $75.86 | Professional | 52 · Reduced service | $23.44 | $37.15 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.33 Median $14.79 Typical High $30.20 | Professional | 53 · Discontinued | $9.33 | $14.79 | $30.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $35.48 Median $54.95 Typical High $112.20 | Professional | 54 · Surgery only | $35.48 | $54.95 | $112.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.08 Median $11.22 Typical High $22.39 | Professional | 55 · Aftercare only | $7.08 | $11.22 | $22.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.68 Median $7.41 Typical High $15.14 | Professional | 56 · Pre-op care only | $4.68 | $7.41 | $15.14 |
Where Kentucky sits
The same service costs 3.5 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· 50th of 51
$67.61
AK $224DC $63.10
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.