How much rates vary
Facilitymedian $1,514 · 10th to 90th $309 to $5,370Professionalmedian $288 · 10th to 90th $151 to $525
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 $169.82 Median $354.81 Typical High $851.14 | Facility | None | $169.82 | $354.81 | $851.14 |
Aetna Setting Professional Modifier None Typical Low $162.18 Median $338.84 Typical High $436.52 | Professional | None | $162.18 | $338.84 | $436.52 |
Anthem BCBS Setting Facility Modifier None Typical Low $891.25 Median $2,344.23 Typical High $10,000.00 | Facility | None | $891.25 | $2,344.23 | $10,000.00 |
Anthem BCBS Setting Professional Modifier None Typical Low $147.91 Median $275.42 Typical High $426.58 | Professional | None | $147.91 | $275.42 | $426.58 |
CareSource Setting Facility Modifier None Typical Low $147.91 Median $245.47 Typical High $537.03 | Facility | None | $147.91 | $245.47 | $537.03 |
CareSource Setting Professional Modifier None Typical Low $151.36 Median $213.80 Typical High $251.19 | Professional | None | $151.36 | $213.80 | $251.19 |
Cigna Setting Facility Modifier None Typical Low $263.03 Median $363.08 Typical High $1,659.59 | Facility | None | $263.03 | $363.08 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $154.88 Median $346.74 Typical High $2,041.74 | Professional | None | $154.88 | $346.74 | $2,041.74 |
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 $165.96 Median $338.84 Typical High $630.96 | Professional | None | $165.96 | $338.84 | $630.96 |
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 $85.11 Median $177.83 Typical High $218.78 | Facility | 52 · Reduced service | $85.11 | $177.83 | $218.78 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $33.88 Median $70.79 Typical High $87.10 | Facility | 53 · Discontinued | $33.88 | $70.79 | $87.10 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $125.89 Median $263.03 Typical High $323.59 | Facility | 54 · Surgery only | $125.89 | $263.03 | $323.59 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $25.70 Median $53.70 Typical High $64.57 | Facility | 55 · Aftercare only | $25.70 | $53.70 | $64.57 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $16.98 Median $35.48 Typical High $43.65 | Facility | 56 · Pre-op care only | $16.98 | $35.48 | $43.65 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $81.28 Median $169.82 Typical High $218.78 | Professional | 52 · Reduced service | $81.28 | $169.82 | $218.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $67.61 Typical High $87.10 | Professional | 53 · Discontinued | $32.36 | $67.61 | $87.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $123.03 Median $251.19 Typical High $323.59 | Professional | 54 · Surgery only | $123.03 | $251.19 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $51.29 Typical High $64.57 | Professional | 55 · Aftercare only | $24.55 | $51.29 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $33.88 Typical High $43.65 | Professional | 56 · Pre-op care only | $16.22 | $33.88 | $43.65 |
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
$309
WI $871KY $309
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.