How much rates vary
Facilitymedian $1,318 · 10th to 90th $427 to $3,548Professionalmedian $417 · 10th to 90th $309 to $977
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 $346.74 Median $426.58 Typical High $1,122.02 | Facility | None | $346.74 | $426.58 | $1,122.02 |
Aetna Setting Professional Modifier None Typical Low $338.84 Median $426.58 Typical High $537.03 | Professional | None | $338.84 | $426.58 | $537.03 |
Anthem BCBS Setting Facility Modifier None Typical Low $602.56 Median $1,698.24 Typical High $2,884.03 | Facility | None | $602.56 | $1,698.24 | $2,884.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $309.03 Median $380.19 Typical High $977.24 | Professional | None | $309.03 | $380.19 | $977.24 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $467.74 Median $562.34 Typical High $1,479.11 | Professional | 50 · Both sides | $467.74 | $562.34 | $1,479.11 |
CareSource Setting Facility Modifier None Typical Low $309.03 Median $501.19 Typical High $8,128.31 | Facility | None | $309.03 | $501.19 | $8,128.31 |
CareSource Setting Professional Modifier None Typical Low $316.23 Median $436.52 Typical High $512.86 | Professional | None | $316.23 | $436.52 | $512.86 |
Cigna Setting Facility Modifier None Typical Low $537.03 Median $1,318.26 Typical High $6,025.60 | Facility | None | $537.03 | $1,318.26 | $6,025.60 |
Cigna Setting Professional Modifier None Typical Low $323.59 Median $501.19 Typical High $6,025.60 | Professional | None | $323.59 | $501.19 | $6,025.60 |
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 $457.09 Median $794.33 Typical High $2,454.71 | Facility | None | $457.09 | $794.33 | $2,454.71 |
United Setting Professional Modifier None Typical Low $346.74 Median $489.78 Typical High $707.95 | Professional | None | $346.74 | $489.78 | $707.95 |
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 $173.78 Median $213.80 Typical High $562.34 | Facility | 52 · Reduced service | $173.78 | $213.80 | $562.34 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $69.18 Median $85.11 Typical High $229.09 | Facility | 53 · Discontinued | $69.18 | $85.11 | $229.09 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $263.03 Median $323.59 Typical High $851.14 | Facility | 54 · Surgery only | $263.03 | $323.59 | $851.14 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $52.48 Median $64.57 Typical High $169.82 | Facility | 55 · Aftercare only | $52.48 | $64.57 | $169.82 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $34.67 Median $42.66 Typical High $112.20 | Facility | 56 · Pre-op care only | $34.67 | $42.66 | $112.20 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $169.82 Median $208.93 Typical High $257.04 | Professional | 52 · Reduced service | $169.82 | $208.93 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $83.18 Typical High $104.71 | Professional | 53 · Discontinued | $67.61 | $83.18 | $104.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $316.23 Typical High $389.05 | Professional | 54 · Surgery only | $251.19 | $316.23 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $63.10 Typical High $77.62 | Professional | 55 · Aftercare only | $50.12 | $63.10 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $41.69 Typical High $51.29 | Professional | 56 · Pre-op care only | $33.88 | $41.69 | $51.29 |
Where Kentucky sits
The same service costs 9.3 times more in Wyoming than in Delaware. 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
WY $10,585DE $1,135
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.