How much rates vary
Facilitymedian $1,072 · 10th to 90th $151 to $2,818Professionalmedian $135 · 10th to 90th $78 to $240
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 $87.10 Median $190.55 Typical High $851.14 | Facility | None | $87.10 | $190.55 | $851.14 |
Aetna Setting Professional Modifier None Typical Low $87.10 Median $190.55 Typical High $245.47 | Professional | None | $87.10 | $190.55 | $245.47 |
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 $74.13 Median $131.83 Typical High $177.83 | Professional | None | $74.13 | $131.83 | $177.83 |
CareSource Setting Facility Modifier None Typical Low $79.43 Median $131.83 Typical High $1,071.52 | Facility | None | $79.43 | $131.83 | $1,071.52 |
CareSource Setting Professional Modifier None Typical Low $74.13 Median $104.71 Typical High $138.04 | Professional | None | $74.13 | $104.71 | $138.04 |
Cigna Setting Facility Modifier None Typical Low $151.36 Median $758.58 Typical High $1,318.26 | Facility | None | $151.36 | $758.58 | $1,318.26 |
Cigna Setting Professional Modifier None Typical Low $85.11 Median $190.55 Typical High $1,122.02 | Professional | None | $85.11 | $190.55 | $1,122.02 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $61.66 | Professional | None | $33.11 | $33.11 | $61.66 |
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 $100.00 Median $162.18 Typical High $257.04 | Professional | None | $100.00 | $162.18 | $257.04 |
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 $43.65 Median $95.50 Typical High $123.03 | Facility | 52 · Reduced service | $43.65 | $95.50 | $123.03 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $17.38 Median $38.90 Typical High $48.98 | Facility | 53 · Discontinued | $17.38 | $38.90 | $48.98 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $66.07 Median $144.54 Typical High $181.97 | Facility | 54 · Surgery only | $66.07 | $144.54 | $181.97 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $13.18 Median $28.84 Typical High $36.31 | Facility | 55 · Aftercare only | $13.18 | $28.84 | $36.31 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $8.71 Median $19.05 Typical High $24.55 | Facility | 56 · Pre-op care only | $8.71 | $19.05 | $24.55 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $43.65 Median $95.50 Typical High $123.03 | Professional | 52 · Reduced service | $43.65 | $95.50 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.38 Median $38.02 Typical High $48.98 | Professional | 53 · Discontinued | $17.38 | $38.02 | $48.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $66.07 Median $141.25 Typical High $181.97 | Professional | 54 · Surgery only | $66.07 | $141.25 | $181.97 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $28.84 Typical High $36.31 | Professional | 55 · Aftercare only | $13.18 | $28.84 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $19.05 Typical High $24.55 | Professional | 56 · Pre-op care only | $8.71 | $19.05 | $24.55 |
Where Kentucky sits
The same service costs 4.2 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· 49th of 51
$135
AK $468DC $112
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.