How much rates vary
Facilitymedian $1,072 · 10th to 90th $132 to $2,818Professionalmedian $138 · 10th to 90th $71 to $229
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 $77.62 Median $199.53 Typical High $851.14 | Facility | None | $77.62 | $199.53 | $851.14 |
Aetna Setting Professional Modifier None Typical Low $77.62 Median $165.96 Typical High $251.19 | Professional | None | $77.62 | $165.96 | $251.19 |
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 $70.79 Median $138.04 Typical High $194.98 | Professional | None | $70.79 | $138.04 | $194.98 |
CareSource Setting Facility Modifier None Typical Low $72.44 Median $117.49 Typical High $831.76 | Facility | None | $72.44 | $117.49 | $831.76 |
CareSource Setting Professional Modifier None Typical Low $66.07 Median $93.33 Typical High $117.49 | Professional | None | $66.07 | $93.33 | $117.49 |
Cigna Setting Facility Modifier None Typical Low $131.83 Median $588.84 Typical High $1,318.26 | Facility | None | $131.83 | $588.84 | $1,318.26 |
Cigna Setting Professional Modifier None Typical Low $75.86 Median $199.53 Typical High $1,174.90 | Professional | None | $75.86 | $199.53 | $1,174.90 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $51.29 | Professional | None | $33.11 | $33.11 | $51.29 |
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 $87.10 Median $162.18 Typical High $245.47 | Professional | None | $87.10 | $162.18 | $245.47 |
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 $38.90 Median $87.10 Typical High $125.89 | Facility | 52 · Reduced service | $38.90 | $87.10 | $125.89 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $15.49 Median $34.67 Typical High $51.29 | Facility | 53 · Discontinued | $15.49 | $34.67 | $51.29 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $58.88 Median $128.82 Typical High $190.55 | Facility | 54 · Surgery only | $58.88 | $128.82 | $190.55 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $11.75 Median $25.70 Typical High $38.02 | Facility | 55 · Aftercare only | $11.75 | $25.70 | $38.02 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $7.76 Median $17.38 Typical High $25.12 | Facility | 56 · Pre-op care only | $7.76 | $17.38 | $25.12 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $38.90 Median $87.10 Typical High $125.89 | Professional | 52 · Reduced service | $38.90 | $87.10 | $125.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.49 Median $34.67 Typical High $51.29 | Professional | 53 · Discontinued | $15.49 | $34.67 | $51.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $58.88 Median $128.82 Typical High $190.55 | Professional | 54 · Surgery only | $58.88 | $128.82 | $190.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $25.70 Typical High $38.02 | Professional | 55 · Aftercare only | $11.75 | $25.70 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $17.38 Typical High $25.12 | Professional | 56 · Pre-op care only | $7.76 | $17.38 | $25.12 |
Where Kentucky sits
The same service costs 4.1 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
$138
AK $398DC $97.72
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.