How much rates vary
Facilitymedian $117 · 10th to 90th $63 to $3,311Professionalmedian $98 · 10th to 90th $65 to $537
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 $72.44 Median $117.49 Typical High $851.14 | Facility | None | $72.44 | $117.49 | $851.14 |
Aetna Setting Professional Modifier None Typical Low $69.18 Median $102.33 Typical High $154.88 | Professional | None | $69.18 | $102.33 | $154.88 |
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 $58.88 Median $87.10 Typical High $537.03 | Professional | None | $58.88 | $87.10 | $537.03 |
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 $91.20 Typical High $107.15 | Professional | None | $70.79 | $91.20 | $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 $64.57 Median $120.23 Typical High $3,715.35 | Professional | None | $64.57 | $120.23 | $3,715.35 |
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 $70.79 Median $104.71 Typical High $169.82 | Professional | None | $70.79 | $104.71 | $169.82 |
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 $35.48 Median $58.88 Typical High $338.84 | Facility | 52 · Reduced service | $35.48 | $58.88 | $338.84 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $14.45 Median $23.44 Typical High $138.04 | Facility | 53 · Discontinued | $14.45 | $23.44 | $138.04 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $53.70 Median $87.10 Typical High $512.86 | Facility | 54 · Surgery only | $53.70 | $87.10 | $512.86 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $10.72 Median $17.38 Typical High $102.33 | Facility | 55 · Aftercare only | $10.72 | $17.38 | $102.33 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $7.24 Median $11.75 Typical High $67.61 | Facility | 56 · Pre-op care only | $7.24 | $11.75 | $67.61 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $34.67 Median $46.77 Typical High $74.13 | Professional | 52 · Reduced service | $34.67 | $46.77 | $74.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $19.05 Typical High $29.51 | Professional | 53 · Discontinued | $13.80 | $19.05 | $29.51 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $51.29 Median $70.79 Typical High $109.65 | Professional | 54 · Surgery only | $51.29 | $70.79 | $109.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $14.13 Typical High $21.88 | Professional | 55 · Aftercare only | $10.23 | $14.13 | $21.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $9.33 Typical High $14.79 | Professional | 56 · Pre-op care only | $6.92 | $9.33 | $14.79 |
Where Kentucky sits
The same service costs 3.2 times more in Alaska than in Florida. 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
$97.72
AK $282FL $87.10
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.