How much rates vary
Facilitymedian $1,072 · 10th to 90th $129 to $2,818Professionalmedian $105 · 10th to 90th $74 to $245
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 $81.28 Median $134.90 Typical High $851.14 | Facility | None | $81.28 | $134.90 | $851.14 |
Aetna Setting Professional Modifier None Typical Low $79.43 Median $128.82 Typical High $177.83 | Professional | None | $79.43 | $128.82 | $177.83 |
Ambetter Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $144.54 | Professional | None | $144.54 | $144.54 | $144.54 |
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 $72.44 Median $100.00 Typical High $245.47 | Professional | None | $72.44 | $100.00 | $245.47 |
CareSource Setting Facility Modifier None Typical Low $72.44 Median $117.49 Typical High $537.03 | Facility | None | $72.44 | $117.49 | $537.03 |
CareSource Setting Professional Modifier None Typical Low $67.61 Median $100.00 Typical High $120.23 | Professional | None | $67.61 | $100.00 | $120.23 |
Cigna Setting Facility Modifier None Typical Low $128.82 Median $363.08 Typical High $1,318.26 | Facility | None | $128.82 | $363.08 | $1,318.26 |
Cigna Setting Professional Modifier None Typical Low $75.86 Median $147.91 Typical High $1,513.56 | Professional | None | $75.86 | $147.91 | $1,513.56 |
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 $323.59 Median $588.84 Typical High $1,621.81 | Facility | None | $323.59 | $588.84 | $1,621.81 |
United Setting Professional Modifier None Typical Low $91.20 Median $144.54 Typical High $229.09 | Professional | None | $91.20 | $144.54 | $229.09 |
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 $40.74 Median $67.61 Typical High $141.25 | Facility | 52 · Reduced service | $40.74 | $67.61 | $141.25 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $16.22 Median $26.92 Typical High $56.23 | Facility | 53 · Discontinued | $16.22 | $26.92 | $56.23 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $61.66 Median $100.00 Typical High $208.93 | Facility | 54 · Surgery only | $61.66 | $100.00 | $208.93 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $12.30 Median $19.95 Typical High $41.69 | Facility | 55 · Aftercare only | $12.30 | $19.95 | $41.69 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $8.13 Median $13.49 Typical High $28.18 | Facility | 56 · Pre-op care only | $8.13 | $13.49 | $28.18 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $39.81 Median $63.10 Typical High $81.28 | Professional | 52 · Reduced service | $39.81 | $63.10 | $81.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.85 Median $25.70 Typical High $33.11 | Professional | 53 · Discontinued | $15.85 | $25.70 | $33.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $60.26 Median $95.50 Typical High $123.03 | Professional | 54 · Surgery only | $60.26 | $95.50 | $123.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $19.05 Typical High $24.55 | Professional | 55 · Aftercare only | $12.02 | $19.05 | $24.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $12.59 Typical High $16.60 | Professional | 56 · Pre-op care only | $7.94 | $12.59 | $16.60 |
Where Kentucky sits
The same service costs 3.6 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
$115
WI $417KY $115
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.