How much rates vary
Facilitymedian $398 · 10th to 90th $68 to $7,762Professionalmedian $251 · 10th to 90th $69 to $513
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 $67.61 Median $363.08 Typical High $794.33 | Facility | None | $67.61 | $363.08 | $794.33 |
Aetna Setting Professional Modifier None Typical Low $67.61 Median $263.03 Typical High $489.78 | Professional | None | $67.61 | $263.03 | $489.78 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,888.44 Median $9,120.11 Typical High $11,220.18 | Facility | None | $5,888.44 | $9,120.11 | $11,220.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $81.28 Median $239.88 Typical High $371.54 | Professional | None | $81.28 | $239.88 | $371.54 |
CareSource Setting Facility Modifier None Typical Low $54.95 Median $66.07 Typical High $102.33 | Facility | None | $54.95 | $66.07 | $102.33 |
CareSource Setting Professional Modifier None Typical Low $70.79 Median $89.13 Typical High $107.15 | Professional | None | $70.79 | $89.13 | $107.15 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $109.65 Typical High $109.65 | Facility | None | $34.67 | $109.65 | $109.65 |
Cigna Setting Professional Modifier None Typical Low $66.07 Median $371.54 Typical High $1,905.46 | Professional | None | $66.07 | $371.54 | $1,905.46 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $81.28 | Professional | None | $33.11 | $33.11 | $81.28 |
United Setting Facility Modifier None Typical Low $741.31 Median $4,073.80 Typical High $8,511.38 | Facility | None | $741.31 | $4,073.80 | $8,511.38 |
United Setting Professional Modifier None Typical Low $83.18 Median $331.13 Typical High $562.34 | Professional | None | $83.18 | $331.13 | $562.34 |
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 $33.88 Median $72.44 Typical High $257.04 | Facility | 52 · Reduced service | $33.88 | $72.44 | $257.04 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $13.49 Median $28.84 Typical High $104.71 | Facility | 53 · Discontinued | $13.49 | $28.84 | $104.71 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $50.12 Median $109.65 Typical High $389.05 | Facility | 54 · Surgery only | $50.12 | $109.65 | $389.05 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $10.23 Median $21.88 Typical High $77.62 | Facility | 55 · Aftercare only | $10.23 | $21.88 | $77.62 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $8.51 Median $36.31 Typical High $51.29 | Facility | 56 · Pre-op care only | $8.51 | $36.31 | $51.29 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $33.88 Median $125.89 Typical High $234.42 | Professional | 52 · Reduced service | $33.88 | $125.89 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.49 Median $50.12 Typical High $93.33 | Professional | 53 · Discontinued | $13.49 | $50.12 | $93.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $50.12 Median $186.21 Typical High $346.74 | Professional | 54 · Surgery only | $50.12 | $186.21 | $346.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $37.15 Typical High $69.18 | Professional | 55 · Aftercare only | $10.23 | $37.15 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $25.12 Typical High $46.77 | Professional | 56 · Pre-op care only | $6.76 | $25.12 | $46.77 |
Where Kentucky sits
The same service costs 5.6 times more in Wisconsin than in Maryland. 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· 46th of 51
$251
WI $617MD $110
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.