How much rates vary
Facilitymedian $1,288 · 10th to 90th $389 to $4,467Professionalmedian $1,023 · 10th to 90th $295 to $2,512
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 $389.05 Median $851.14 Typical High $2,187.76 | Facility | None | $389.05 | $851.14 | $2,187.76 |
Aetna Setting Professional Modifier None Typical Low $380.19 Median $1,479.11 Typical High $2,187.76 | Professional | None | $380.19 | $1,479.11 | $2,187.76 |
Ambetter Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $363.08 | Professional | None | $363.08 | $363.08 | $363.08 |
Anthem BCBS Setting Facility Modifier None Typical Low $758.58 Median $5,011.87 Typical High $11,220.18 | Facility | None | $758.58 | $5,011.87 | $11,220.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $295.12 Median $1,000.00 Typical High $1,737.80 | Professional | None | $295.12 | $1,000.00 | $1,737.80 |
CareSource Setting Facility Modifier None Typical Low $302.00 Median $562.34 Typical High $2,238.72 | Facility | None | $302.00 | $562.34 | $2,238.72 |
CareSource Setting Professional Modifier None Typical Low $323.59 Median $489.78 Typical High $575.44 | Professional | None | $323.59 | $489.78 | $575.44 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $831.76 Typical High $2,089.30 | Facility | None | $34.67 | $831.76 | $2,089.30 |
Cigna Setting Professional Modifier None Typical Low $363.08 Median $1,479.11 Typical High $16,218.10 | Professional | None | $363.08 | $1,479.11 | $16,218.10 |
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 $389.05 Median $1,412.54 Typical High $2,754.23 | Professional | None | $389.05 | $1,412.54 | $2,754.23 |
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 $194.98 Median $239.88 Typical High $1,096.48 | Facility | 52 · Reduced service | $194.98 | $239.88 | $1,096.48 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $77.62 Median $95.50 Typical High $436.52 | Facility | 53 · Discontinued | $77.62 | $95.50 | $436.52 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $295.12 Median $363.08 Typical High $1,621.81 | Facility | 54 · Surgery only | $295.12 | $363.08 | $1,621.81 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $58.88 Median $72.44 Typical High $323.59 | Facility | 55 · Aftercare only | $58.88 | $72.44 | $323.59 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $38.90 Median $47.86 Typical High $218.78 | Facility | 56 · Pre-op care only | $38.90 | $47.86 | $218.78 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $190.55 Median $257.04 Typical High $933.25 | Professional | 52 · Reduced service | $190.55 | $257.04 | $933.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $102.33 Typical High $380.19 | Professional | 53 · Discontinued | $75.86 | $102.33 | $380.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $281.84 Median $389.05 Typical High $1,412.54 | Professional | 54 · Surgery only | $281.84 | $389.05 | $1,412.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $77.62 Typical High $281.84 | Professional | 55 · Aftercare only | $57.54 | $77.62 | $281.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $51.29 Typical High $186.21 | Professional | 56 · Pre-op care only | $38.02 | $51.29 | $186.21 |
Where Kentucky sits
The same service costs 3.6 times more in Iowa than in Nebraska. 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· 48th of 51
$1,148
IA $2,692NE $741
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.