How much rates vary
Facilitymedian $115 · 10th to 90th $54 to $1,479Professionalmedian $89 · 10th to 90th $49 to $158
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 $53.70 Median $102.33 Typical High $794.33 | Facility | None | $53.70 | $102.33 | $794.33 |
Aetna Setting Professional Modifier None Typical Low $51.29 Median $95.50 Typical High $138.04 | Professional | None | $51.29 | $95.50 | $138.04 |
Ambetter Setting Professional Modifier None Typical Low $87.10 Median $87.10 Typical High $104.71 | Professional | None | $87.10 | $87.10 | $104.71 |
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 $46.77 Median $81.28 Typical High $158.49 | Professional | None | $46.77 | $81.28 | $158.49 |
CareSource Setting Facility Modifier None Typical Low $40.74 Median $77.62 Typical High $104.71 | Facility | None | $40.74 | $77.62 | $104.71 |
CareSource Setting Professional Modifier None Typical Low $47.86 Median $67.61 Typical High $79.43 | Professional | None | $47.86 | $67.61 | $79.43 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $79.43 Typical High $398.11 | Facility | None | $34.67 | $79.43 | $398.11 |
Cigna Setting Professional Modifier None Typical Low $48.98 Median $97.72 Typical High $724.44 | Professional | None | $48.98 | $97.72 | $724.44 |
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 $61.66 Median $97.72 Typical High $158.49 | Professional | None | $61.66 | $97.72 | $158.49 |
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 $26.92 Median $47.86 Typical High $67.61 | Facility | 52 · Reduced service | $26.92 | $47.86 | $67.61 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $10.72 Median $19.50 Typical High $27.54 | Facility | 53 · Discontinued | $10.72 | $19.50 | $27.54 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $39.81 Median $72.44 Typical High $102.33 | Facility | 54 · Surgery only | $39.81 | $72.44 | $102.33 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $7.94 Median $14.45 Typical High $20.42 | Facility | 55 · Aftercare only | $7.94 | $14.45 | $20.42 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $5.37 Median $9.55 Typical High $13.80 | Facility | 56 · Pre-op care only | $5.37 | $9.55 | $13.80 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $25.70 Median $45.71 Typical High $58.88 | Professional | 52 · Reduced service | $25.70 | $45.71 | $58.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.23 Median $18.20 Typical High $23.44 | Professional | 53 · Discontinued | $10.23 | $18.20 | $23.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $38.90 Median $69.18 Typical High $89.13 | Professional | 54 · Surgery only | $38.90 | $69.18 | $89.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.76 Median $13.80 Typical High $17.78 | Professional | 55 · Aftercare only | $7.76 | $13.80 | $17.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.13 Median $9.12 Typical High $11.75 | Professional | 56 · Pre-op care only | $5.13 | $9.12 | $11.75 |
Where Kentucky sits
The same service costs 2.8 times more in Wisconsin 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.
Kentucky· 51st of 51
$91.20
WI $257KY $91.20
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.