How much rates vary
Facilitymedian $1,096 · 10th to 90th $257 to $4,467Professionalmedian $794 · 10th to 90th $229 to $1,413
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 $257.04 Median $851.14 Typical High $1,348.96 | Facility | None | $257.04 | $851.14 | $1,348.96 |
Aetna Setting Professional Modifier None Typical Low $251.19 Median $1,000.00 Typical High $1,348.96 | Professional | None | $251.19 | $1,000.00 | $1,348.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $758.58 Median $5,011.87 Typical High $11,220.18 | Facility | None | $758.58 | $5,011.87 | $11,220.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $229.09 Median $812.83 Typical High $1,174.90 | Professional | None | $229.09 | $812.83 | $1,174.90 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $346.74 Median $1,230.27 Typical High $1,778.28 | Professional | 50 · Both sides | $346.74 | $1,230.27 | $1,778.28 |
CareSource Setting Facility Modifier None Typical Low $229.09 Median $371.54 Typical High $2,818.38 | Facility | None | $229.09 | $371.54 | $2,818.38 |
CareSource Setting Professional Modifier None Typical Low $229.09 Median $323.59 Typical High $380.19 | Professional | None | $229.09 | $323.59 | $380.19 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $831.76 Typical High $2,089.30 | Facility | None | $34.67 | $831.76 | $2,089.30 |
Cigna Setting Professional Modifier None Typical Low $239.88 Median $1,000.00 Typical High $5,128.61 | Professional | None | $239.88 | $1,000.00 | $5,128.61 |
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 $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 $281.84 Median $912.01 Typical High $1,737.80 | Professional | None | $281.84 | $912.01 | $1,737.80 |
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 $128.82 Median $173.78 Typical High $676.08 | Facility | 52 · Reduced service | $128.82 | $173.78 | $676.08 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $51.29 Median $70.79 Typical High $269.15 | Facility | 53 · Discontinued | $51.29 | $70.79 | $269.15 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $194.98 Median $263.03 Typical High $1,000.00 | Facility | 54 · Surgery only | $194.98 | $263.03 | $1,000.00 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $38.90 Median $52.48 Typical High $199.53 | Facility | 55 · Aftercare only | $38.90 | $52.48 | $199.53 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $25.70 Median $34.67 Typical High $134.90 | Facility | 56 · Pre-op care only | $25.70 | $34.67 | $134.90 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $123.03 Median $173.78 Typical High $645.65 | Professional | 52 · Reduced service | $123.03 | $173.78 | $645.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $70.79 Typical High $257.04 | Professional | 53 · Discontinued | $50.12 | $70.79 | $257.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $263.03 Typical High $954.99 | Professional | 54 · Surgery only | $186.21 | $263.03 | $954.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $52.48 Typical High $190.55 | Professional | 55 · Aftercare only | $37.15 | $52.48 | $190.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $34.67 Typical High $128.82 | Professional | 56 · Pre-op care only | $25.12 | $34.67 | $128.82 |
Where Kentucky sits
The same service costs 3.2 times more in Oklahoma than in Kentucky. 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.
Physician feeFacility fee
OK $6,075KY $1,891
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.