How much rates vary
Facilitymedian $91 · 10th to 90th $32 to $1,479Professionalmedian $65 · 10th to 90th $33 to $166
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 $30.90 Median $74.13 Typical High $794.33 | Facility | None | $30.90 | $74.13 | $794.33 |
Aetna Setting Professional Modifier None Typical Low $30.20 Median $70.79 Typical High $107.15 | Professional | None | $30.20 | $70.79 | $107.15 |
Ambetter Setting Professional Modifier None Typical Low $79.43 Median $79.43 Typical High $85.11 | Professional | None | $79.43 | $79.43 | $85.11 |
Anthem BCBS Setting Facility Modifier None Typical Low $575.44 Median $3,801.89 Typical High $11,220.18 | Facility | None | $575.44 | $3,801.89 | $11,220.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $35.48 Median $60.26 Typical High $177.83 | Professional | None | $35.48 | $60.26 | $177.83 |
CareSource Setting Facility Modifier None Typical Low $26.92 Median $38.90 Typical High $87.10 | Facility | None | $26.92 | $38.90 | $87.10 |
CareSource Setting Professional Modifier None Typical Low $34.67 Median $67.61 Typical High $93.33 | Professional | None | $34.67 | $67.61 | $93.33 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $58.88 Typical High $69.18 | Facility | None | $34.67 | $58.88 | $69.18 |
Cigna Setting Professional Modifier None Typical Low $28.84 Median $75.86 Typical High $512.86 | Professional | None | $28.84 | $75.86 | $512.86 |
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 $70.79 Median $186.21 Typical High $1,148.15 | Facility | None | $70.79 | $186.21 | $1,148.15 |
United Setting Professional Modifier None Typical Low $40.74 Median $70.79 Typical High $128.82 | Professional | None | $40.74 | $70.79 | $128.82 |
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 $15.49 Median $37.15 Typical High $47.86 | Facility | 52 · Reduced service | $15.49 | $37.15 | $47.86 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $6.17 Median $14.79 Typical High $19.05 | Facility | 53 · Discontinued | $6.17 | $14.79 | $19.05 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $22.91 Median $56.23 Typical High $72.44 | Facility | 54 · Surgery only | $22.91 | $56.23 | $72.44 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $4.57 Median $11.22 Typical High $14.45 | Facility | 55 · Aftercare only | $4.57 | $11.22 | $14.45 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $3.09 Median $7.41 Typical High $9.55 | Facility | 56 · Pre-op care only | $3.09 | $7.41 | $9.55 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $15.14 Median $35.48 Typical High $45.71 | Professional | 52 · Reduced service | $15.14 | $35.48 | $45.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.03 Median $14.13 Typical High $18.20 | Professional | 53 · Discontinued | $6.03 | $14.13 | $18.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $22.39 Median $53.70 Typical High $67.61 | Professional | 54 · Surgery only | $22.39 | $53.70 | $67.61 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.47 Median $10.72 Typical High $13.49 | Professional | 55 · Aftercare only | $4.47 | $10.72 | $13.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.02 Median $7.08 Typical High $9.12 | Professional | 56 · Pre-op care only | $3.02 | $7.08 | $9.12 |
Where Kentucky sits
The same service costs 3.1 times more in Wisconsin than in Nebraska. 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· 50th of 51
$64.57
WI $186NE $60.26
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.