How much rates vary
Facilitymedian $1,660 · 10th to 90th $331 to $5,495Professionalmedian $288 · 10th to 90th $186 to $479
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 $208.93 Median $331.13 Typical High $851.14 | Facility | None | $208.93 | $331.13 | $851.14 |
Aetna Setting Professional Modifier None Typical Low $199.53 Median $316.23 Typical High $426.58 | Professional | None | $199.53 | $316.23 | $426.58 |
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 $181.97 Median $251.19 Typical High $478.63 | Professional | None | $181.97 | $251.19 | $478.63 |
CareSource Setting Facility Modifier None Typical Low $181.97 Median $295.12 Typical High $1,621.81 | Facility | None | $181.97 | $295.12 | $1,621.81 |
CareSource Setting Professional Modifier None Typical Low $204.17 Median $263.03 Typical High $309.03 | Professional | None | $204.17 | $263.03 | $309.03 |
Cigna Setting Facility Modifier None Typical Low $316.23 Median $1,148.15 Typical High $1,659.59 | Facility | None | $316.23 | $1,148.15 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $190.55 Median $331.13 Typical High $2,398.83 | Professional | None | $190.55 | $331.13 | $2,398.83 |
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 $707.95 Median $1,174.90 Typical High $3,890.45 | Facility | None | $707.95 | $1,174.90 | $3,890.45 |
United Setting Professional Modifier None Typical Low $204.17 Median $302.00 Typical High $467.74 | Professional | None | $204.17 | $302.00 | $467.74 |
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 $102.33 Median $165.96 Typical High $223.87 | Facility | 52 · Reduced service | $102.33 | $165.96 | $223.87 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $41.69 Median $67.61 Typical High $89.13 | Facility | 53 · Discontinued | $41.69 | $67.61 | $89.13 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $154.88 Median $251.19 Typical High $338.84 | Facility | 54 · Surgery only | $154.88 | $251.19 | $338.84 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $30.90 Median $50.12 Typical High $67.61 | Facility | 55 · Aftercare only | $30.90 | $50.12 | $67.61 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $20.89 Median $33.11 Typical High $44.67 | Facility | 56 · Pre-op care only | $20.89 | $33.11 | $44.67 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $100.00 Median $158.49 Typical High $204.17 | Professional | 52 · Reduced service | $100.00 | $158.49 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $39.81 Median $63.10 Typical High $81.28 | Professional | 53 · Discontinued | $39.81 | $63.10 | $81.28 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $147.91 Median $234.42 Typical High $309.03 | Professional | 54 · Surgery only | $147.91 | $234.42 | $309.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $47.86 Typical High $61.66 | Professional | 55 · Aftercare only | $30.20 | $47.86 | $61.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $31.62 Typical High $40.74 | Professional | 56 · Pre-op care only | $19.95 | $31.62 | $40.74 |
Where Kentucky sits
The same service costs 7.9 times more in Oklahoma than in Montana. 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.
Physician feeFacility fee
OK $5,867MT $745
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.