How much rates vary
Facilitymedian $71 · 10th to 90th $35 to $1,950Professionalmedian $69 · 10th to 90th $32 to $204
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 $35.48 Median $158.49 Typical High $794.33 | Facility | None | $35.48 | $158.49 | $794.33 |
Aetna Setting Professional Modifier None Typical Low $35.48 Median $89.13 Typical High $208.93 | Professional | None | $35.48 | $89.13 | $208.93 |
Ambetter Setting Professional Modifier None Typical Low $34.67 Median $34.67 Typical High $34.67 | Professional | None | $34.67 | $34.67 | $34.67 |
Anthem BCBS Setting Facility Modifier None Typical Low $9,120.11 Median $10,715.19 Typical High $11,220.18 | Facility | None | $9,120.11 | $10,715.19 | $11,220.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $30.90 Median $67.61 Typical High $141.25 | Professional | None | $30.90 | $67.61 | $141.25 |
CareSource Setting Facility Modifier None Typical Low $28.84 Median $34.67 Typical High $54.95 | Facility | None | $28.84 | $34.67 | $54.95 |
CareSource Setting Professional Modifier None Typical Low $37.15 Median $47.86 Typical High $56.23 | Professional | None | $37.15 | $47.86 | $56.23 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $57.54 Typical High $57.54 | Facility | None | $34.67 | $57.54 | $57.54 |
Cigna Setting Professional Modifier None Typical Low $34.67 Median $158.49 Typical High $831.76 | Professional | None | $34.67 | $158.49 | $831.76 |
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 $50.12 Median $416.87 Typical High $1,949.84 | Facility | None | $50.12 | $416.87 | $1,949.84 |
United Setting Professional Modifier None Typical Low $39.81 Median $107.15 Typical High $223.87 | Professional | None | $39.81 | $107.15 | $223.87 |
11 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 $17.78 Median $26.92 Typical High $100.00 | Facility | 52 · Reduced service | $17.78 | $26.92 | $100.00 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $7.08 Median $10.96 Typical High $39.81 | Facility | 53 · Discontinued | $7.08 | $10.96 | $39.81 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $26.92 Median $40.74 Typical High $151.36 | Facility | 54 · Surgery only | $26.92 | $40.74 | $151.36 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $5.37 Median $8.13 Typical High $30.20 | Facility | 55 · Aftercare only | $5.37 | $8.13 | $30.20 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $3.55 Median $5.37 Typical High $19.95 | Facility | 56 · Pre-op care only | $3.55 | $5.37 | $19.95 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $17.78 Median $27.54 Typical High $100.00 | Professional | 52 · Reduced service | $17.78 | $27.54 | $100.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.08 Median $10.96 Typical High $39.81 | Professional | 53 · Discontinued | $7.08 | $10.96 | $39.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $26.92 Median $40.74 Typical High $151.36 | Professional | 54 · Surgery only | $26.92 | $40.74 | $151.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.37 Median $8.32 Typical High $30.20 | Professional | 55 · Aftercare only | $5.37 | $8.32 | $30.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.55 Median $5.62 Typical High $19.95 | Professional | 56 · Pre-op care only | $3.55 | $5.62 | $19.95 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $38.90 Median $38.90 Typical High $38.90 | Professional | GC · Resident with teaching physician | $38.90 | $38.90 | $38.90 |
Where Kentucky sits
The same service costs 4.5 times more in Wisconsin than in Michigan. 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· 48th of 51
$69.18
WI $251MI $56.23
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.