How much rates vary
Facilitymedian $741 · 10th to 90th $204 to $7,762Professionalmedian $617 · 10th to 90th $186 to $1,122
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 $204.17 Median $741.31 Typical High $1,148.15 | Facility | None | $204.17 | $741.31 | $1,148.15 |
Aetna Setting Professional Modifier None Typical Low $204.17 Median $676.08 Typical High $933.25 | Professional | None | $204.17 | $676.08 | $933.25 |
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 $181.97 Median $616.60 Typical High $812.83 | Professional | None | $181.97 | $616.60 | $812.83 |
CareSource Setting Facility Modifier None Typical Low $165.96 Median $194.98 Typical High $309.03 | Facility | None | $165.96 | $194.98 | $309.03 |
CareSource Setting Professional Modifier None Typical Low $208.93 Median $269.15 Typical High $316.23 | Professional | None | $208.93 | $269.15 | $316.23 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $331.13 Typical High $331.13 | Facility | None | $34.67 | $331.13 | $331.13 |
Cigna Setting Professional Modifier None Typical Low $194.98 Median $741.31 Typical High $3,890.45 | Professional | None | $194.98 | $741.31 | $3,890.45 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $186.21 | Professional | None | $33.11 | $33.11 | $186.21 |
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 $239.88 Median $741.31 Typical High $1,258.93 | Professional | None | $239.88 | $741.31 | $1,258.93 |
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 $102.33 Median $162.18 Typical High $575.44 | Facility | 52 · Reduced service | $102.33 | $162.18 | $575.44 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $40.74 Median $66.07 Typical High $229.09 | Facility | 53 · Discontinued | $40.74 | $66.07 | $229.09 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $151.36 Median $245.47 Typical High $851.14 | Facility | 54 · Surgery only | $151.36 | $245.47 | $851.14 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $30.20 Median $48.98 Typical High $169.82 | Facility | 55 · Aftercare only | $30.20 | $48.98 | $169.82 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $20.42 Median $33.11 Typical High $114.82 | Facility | 56 · Pre-op care only | $20.42 | $33.11 | $114.82 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $102.33 Median $316.23 Typical High $467.74 | Professional | 52 · Reduced service | $102.33 | $316.23 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $125.89 Typical High $186.21 | Professional | 53 · Discontinued | $40.74 | $125.89 | $186.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $151.36 Median $478.63 Typical High $707.95 | Professional | 54 · Surgery only | $151.36 | $478.63 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $95.50 Typical High $141.25 | Professional | 55 · Aftercare only | $30.20 | $95.50 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $63.10 Typical High $93.33 | Professional | 56 · Pre-op care only | $20.42 | $63.10 | $93.33 |
Where Kentucky sits
The same service costs 5.4 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· 44th of 51
$617
WI $1,514MD $282
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.