How much rates vary
Facilitymedian $1,072 · 10th to 90th $182 to $2,818Professionalmedian $151 · 10th to 90th $93 to $251
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 $107.15 Median $204.17 Typical High $851.14 | Facility | None | $107.15 | $204.17 | $851.14 |
Aetna Setting Professional Modifier None Typical Low $107.15 Median $158.49 Typical High $257.04 | Professional | None | $107.15 | $158.49 | $257.04 |
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 $93.33 Median $144.54 Typical High $204.17 | Professional | None | $93.33 | $144.54 | $204.17 |
CareSource Setting Facility Modifier None Typical Low $100.00 Median $162.18 Typical High $1,071.52 | Facility | None | $100.00 | $162.18 | $1,071.52 |
CareSource Setting Professional Modifier None Typical Low $102.33 Median $128.82 Typical High $162.18 | Professional | None | $102.33 | $128.82 | $162.18 |
Cigna Setting Facility Modifier None Typical Low $181.97 Median $758.58 Typical High $1,318.26 | Facility | None | $181.97 | $758.58 | $1,318.26 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $199.53 Typical High $1,148.15 | Professional | None | $104.71 | $199.53 | $1,148.15 |
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 $112.20 Median $177.83 Typical High $275.42 | Professional | None | $112.20 | $177.83 | $275.42 |
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 $53.70 Median $77.62 Typical High $128.82 | Facility | 52 · Reduced service | $53.70 | $77.62 | $128.82 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $21.38 Median $30.90 Typical High $51.29 | Facility | 53 · Discontinued | $21.38 | $30.90 | $51.29 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $81.28 Median $117.49 Typical High $190.55 | Facility | 54 · Surgery only | $81.28 | $117.49 | $190.55 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $16.22 Median $23.44 Typical High $38.02 | Facility | 55 · Aftercare only | $16.22 | $23.44 | $38.02 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $10.72 Median $15.49 Typical High $25.70 | Facility | 56 · Pre-op care only | $10.72 | $15.49 | $25.70 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $53.70 Median $77.62 Typical High $128.82 | Professional | 52 · Reduced service | $53.70 | $77.62 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $30.90 Typical High $51.29 | Professional | 53 · Discontinued | $21.38 | $30.90 | $51.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $81.28 Median $117.49 Typical High $190.55 | Professional | 54 · Surgery only | $81.28 | $117.49 | $190.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $23.44 Typical High $38.02 | Professional | 55 · Aftercare only | $16.22 | $23.44 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $15.49 Typical High $25.70 | Professional | 56 · Pre-op care only | $10.72 | $15.49 | $25.70 |
Where Kentucky sits
The same service costs 3.8 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
$151
AK $490DC $129
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.