How much rates vary
Facilitymedian $158 · 10th to 90th $74 to $1,778Professionalmedian $100 · 10th to 90th $65 to $263
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 $74.13 Median $158.49 Typical High $851.14 | Facility | None | $74.13 | $158.49 | $851.14 |
Aetna Setting Professional Modifier None Typical Low $70.79 Median $147.91 Typical High $190.55 | Professional | None | $70.79 | $147.91 | $190.55 |
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 $63.10 Median $95.50 Typical High $263.03 | Professional | None | $63.10 | $95.50 | $263.03 |
CareSource Setting Facility Modifier None Typical Low $64.57 Median $107.15 Typical High $177.83 | Facility | None | $64.57 | $107.15 | $177.83 |
CareSource Setting Professional Modifier None Typical Low $66.07 Median $93.33 Typical High $109.65 | Professional | None | $66.07 | $93.33 | $109.65 |
Cigna Setting Facility Modifier None Typical Low $114.82 Median $138.04 Typical High $1,318.26 | Facility | None | $114.82 | $138.04 | $1,318.26 |
Cigna Setting Professional Modifier None Typical Low $67.61 Median $147.91 Typical High $812.83 | Professional | None | $67.61 | $147.91 | $812.83 |
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 $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 $74.13 Median $123.03 Typical High $199.53 | Professional | None | $74.13 | $123.03 | $199.53 |
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 $37.15 Median $72.44 Typical High $95.50 | Facility | 52 · Reduced service | $37.15 | $72.44 | $95.50 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $14.79 Median $29.51 Typical High $38.90 | Facility | 53 · Discontinued | $14.79 | $29.51 | $38.90 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $54.95 Median $109.65 Typical High $144.54 | Facility | 54 · Surgery only | $54.95 | $109.65 | $144.54 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $10.96 Median $21.88 Typical High $28.84 | Facility | 55 · Aftercare only | $10.96 | $21.88 | $28.84 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $7.41 Median $14.79 Typical High $19.05 | Facility | 56 · Pre-op care only | $7.41 | $14.79 | $19.05 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $35.48 Median $72.44 Typical High $95.50 | Professional | 52 · Reduced service | $35.48 | $72.44 | $95.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.13 Median $29.51 Typical High $38.90 | Professional | 53 · Discontinued | $14.13 | $29.51 | $38.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $53.70 Median $109.65 Typical High $144.54 | Professional | 54 · Surgery only | $53.70 | $109.65 | $144.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.72 Median $21.88 Typical High $28.84 | Professional | 55 · Aftercare only | $10.72 | $21.88 | $28.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.08 Median $14.79 Typical High $19.05 | Professional | 56 · Pre-op care only | $7.08 | $14.79 | $19.05 |
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
$105
WI $380KY $105
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.