How much rates vary
Facilitymedian $100 · 10th to 90th $71 to $3,311Professionalmedian $89 · 10th to 90th $68 to $145
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 $77.62 Median $100.00 Typical High $851.14 | Facility | None | $77.62 | $100.00 | $851.14 |
Aetna Setting Professional Modifier None Typical Low $77.62 Median $100.00 Typical High $128.82 | Professional | None | $77.62 | $100.00 | $128.82 |
Anthem BCBS Setting Facility Modifier None Typical Low $9,120.11 Median $10,715.19 Typical High $11,220.18 | Facility | None | $9,120.11 | $10,715.19 | $11,220.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $66.07 Median $87.10 Typical High $120.23 | Professional | None | $66.07 | $87.10 | $120.23 |
CareSource Setting Facility Modifier None Typical Low $63.10 Median $75.86 Typical High $117.49 | Facility | None | $63.10 | $75.86 | $117.49 |
CareSource Setting Professional Modifier None Typical Low $81.28 Median $102.33 Typical High $123.03 | Professional | None | $81.28 | $102.33 | $123.03 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $128.82 Typical High $128.82 | Facility | None | $34.67 | $128.82 | $128.82 |
Cigna Setting Professional Modifier None Typical Low $75.86 Median $120.23 Typical High $537.03 | Professional | None | $75.86 | $120.23 | $537.03 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $61.66 | Professional | None | $33.11 | $33.11 | $61.66 |
United Setting Facility Modifier None Typical Low $50.12 Median $416.87 Typical High $1,949.84 | Facility | None | $50.12 | $416.87 | $1,949.84 |
United Setting Professional Modifier None Typical Low $83.18 Median $112.20 Typical High $154.88 | Professional | None | $83.18 | $112.20 | $154.88 |
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 $38.02 Median $41.69 Typical High $50.12 | Facility | 52 · Reduced service | $38.02 | $41.69 | $50.12 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $15.49 Median $16.60 Typical High $20.42 | Facility | 53 · Discontinued | $15.49 | $16.60 | $20.42 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $57.54 Median $63.10 Typical High $75.86 | Facility | 54 · Surgery only | $57.54 | $63.10 | $75.86 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $11.48 Median $12.59 Typical High $15.14 | Facility | 55 · Aftercare only | $11.48 | $12.59 | $15.14 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $7.76 Median $8.32 Typical High $10.00 | Facility | 56 · Pre-op care only | $7.76 | $8.32 | $10.00 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $38.02 Median $50.12 Typical High $63.10 | Professional | 52 · Reduced service | $38.02 | $50.12 | $63.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.49 Median $19.95 Typical High $25.12 | Professional | 53 · Discontinued | $15.49 | $19.95 | $25.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $57.54 Median $75.86 Typical High $93.33 | Professional | 54 · Surgery only | $57.54 | $75.86 | $93.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.48 Median $15.14 Typical High $18.62 | Professional | 55 · Aftercare only | $11.48 | $15.14 | $18.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $10.00 Typical High $12.59 | Professional | 56 · Pre-op care only | $7.76 | $10.00 | $12.59 |
Where Kentucky sits
The same service costs 3.8 times more in Alaska than in Florida. 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· 50th of 51
$89.13
AK $324FL $85.11
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.