How much rates vary
Facilitymedian $724 · 10th to 90th $35 to $2,818Professionalmedian $42 · 10th to 90th $25 to $102
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 $25.70 Median $43.65 Typical High $416.87 | Facility | None | $25.70 | $43.65 | $416.87 |
Aetna Setting Professional Modifier None Typical Low $25.70 Median $43.65 Typical High $70.79 | Professional | None | $25.70 | $43.65 | $70.79 |
Ambetter Setting Professional Modifier None Typical Low $22.91 Median $39.81 Typical High $50.12 | Professional | None | $22.91 | $39.81 | $50.12 |
Anthem BCBS Setting Facility Modifier None Typical Low $588.84 Median $1,698.24 Typical High $2,884.03 | Facility | None | $588.84 | $1,698.24 | $2,884.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $24.55 Median $38.90 Typical High $102.33 | Professional | None | $24.55 | $38.90 | $102.33 |
CareSource Setting Facility Modifier None Typical Low $22.91 Median $524.81 Typical High $933.25 | Facility | None | $22.91 | $524.81 | $933.25 |
CareSource Setting Professional Modifier None Typical Low $29.51 Median $39.81 Typical High $56.23 | Professional | None | $29.51 | $39.81 | $56.23 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $39.81 Typical High $75.86 | Facility | None | $34.67 | $39.81 | $75.86 |
Cigna Setting Professional Modifier None Typical Low $24.55 Median $48.98 Typical High $363.08 | Professional | None | $24.55 | $48.98 | $363.08 |
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 $27.54 Median $46.77 Typical High $87.10 | Professional | None | $27.54 | $46.77 | $87.10 |
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 $12.88 Median $21.88 Typical High $33.88 | Facility | 52 · Reduced service | $12.88 | $21.88 | $33.88 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $5.13 Median $8.71 Typical High $13.80 | Facility | 53 · Discontinued | $5.13 | $8.71 | $13.80 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $19.50 Median $33.11 Typical High $51.29 | Facility | 54 · Surgery only | $19.50 | $33.11 | $51.29 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $3.89 Median $6.61 Typical High $10.23 | Facility | 55 · Aftercare only | $3.89 | $6.61 | $10.23 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $2.57 Median $4.37 Typical High $6.92 | Facility | 56 · Pre-op care only | $2.57 | $4.37 | $6.92 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $12.88 Median $20.89 Typical High $26.92 | Professional | 52 · Reduced service | $12.88 | $20.89 | $26.92 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.13 Median $8.32 Typical High $10.72 | Professional | 53 · Discontinued | $5.13 | $8.32 | $10.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $19.05 Median $30.90 Typical High $40.74 | Professional | 54 · Surgery only | $19.05 | $30.90 | $40.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.80 Median $6.17 Typical High $8.13 | Professional | 55 · Aftercare only | $3.80 | $6.17 | $8.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.57 Median $4.17 Typical High $5.37 | Professional | 56 · Pre-op care only | $2.57 | $4.17 | $5.37 |
Ambetter Setting Professional Modifier 58 · Staged procedure Typical Low $58.88 Median $58.88 Typical High $58.88 | Professional | 58 · Staged procedure | $58.88 | $58.88 | $58.88 |
Where Kentucky sits
The same service costs 3.4 times more in Wisconsin than in Utah. 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· 49th of 51
$43.65
WI $132UT $38.90
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.