How much rates vary
Facilitymedian $1,585 · 10th to 90th $148 to $3,981Professionalmedian $135 · 10th to 90th $83 to $245
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 $162.18 Typical High $851.14 | Facility | None | $87.10 | $162.18 | $851.14 |
Aetna Setting Professional Modifier None Typical Low $87.10 Median $158.49 Typical High $204.17 | Professional | None | $87.10 | $158.49 | $204.17 |
Anthem BCBS Setting Facility Modifier None Typical Low $724.44 Median $1,995.26 Typical High $4,265.80 | Facility | None | $724.44 | $1,995.26 | $4,265.80 |
Anthem BCBS Setting Professional Modifier None Typical Low $79.43 Median $134.90 Typical High $245.47 | Professional | None | $79.43 | $134.90 | $245.47 |
CareSource Setting Facility Modifier None Typical Low $81.28 Median $134.90 Typical High $2,344.23 | Facility | None | $81.28 | $134.90 | $2,344.23 |
CareSource Setting Professional Modifier None Typical Low $74.13 Median $104.71 Typical High $134.90 | Professional | None | $74.13 | $104.71 | $134.90 |
Cigna Setting Facility Modifier None Typical Low $147.91 Median $1,584.89 Typical High $1,737.80 | Facility | None | $147.91 | $1,584.89 | $1,737.80 |
Cigna Setting Professional Modifier None Typical Low $85.11 Median $162.18 Typical High $1,071.52 | Professional | None | $85.11 | $162.18 | $1,071.52 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $83.18 | Professional | None | $33.11 | $33.11 | $83.18 |
United Setting Facility Modifier None Typical Low $707.95 Median $1,174.90 Typical High $3,890.45 | Facility | None | $707.95 | $1,174.90 | $3,890.45 |
United Setting Professional Modifier None Typical Low $104.71 Median $154.88 Typical High $229.09 | Professional | None | $104.71 | $154.88 | $229.09 |
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 $81.28 Typical High $102.33 | Facility | 52 · Reduced service | $43.65 | $81.28 | $102.33 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $17.38 Median $32.36 Typical High $40.74 | Facility | 53 · Discontinued | $17.38 | $32.36 | $40.74 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $66.07 Median $120.23 Typical High $154.88 | Facility | 54 · Surgery only | $66.07 | $120.23 | $154.88 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $13.18 Median $23.99 Typical High $30.90 | Facility | 55 · Aftercare only | $13.18 | $23.99 | $30.90 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $8.71 Median $16.22 Typical High $20.42 | Facility | 56 · Pre-op care only | $8.71 | $16.22 | $20.42 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $43.65 Median $72.44 Typical High $102.33 | Professional | 52 · Reduced service | $43.65 | $72.44 | $102.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.38 Median $29.51 Typical High $40.74 | Professional | 53 · Discontinued | $17.38 | $29.51 | $40.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $66.07 Median $109.65 Typical High $154.88 | Professional | 54 · Surgery only | $66.07 | $109.65 | $154.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $21.88 Typical High $30.90 | Professional | 55 · Aftercare only | $13.18 | $21.88 | $30.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $14.45 Typical High $20.42 | Professional | 56 · Pre-op care only | $8.71 | $14.45 | $20.42 |
Where Kentucky sits
The same service costs 3.6 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· 45th of 51
$138
AK $407DC $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.