How much rates vary
Facilitymedian $162 · 10th to 90th $81 to $1,995Professionalmedian $112 · 10th to 90th $74 to $170
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 $81.28 Median $112.20 Typical High $162.18 | Facility | None | $81.28 | $112.20 | $162.18 |
Aetna Setting Professional Modifier None Typical Low $81.28 Median $112.20 Typical High $162.18 | Professional | None | $81.28 | $112.20 | $162.18 |
Ambetter Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $128.82 | Professional | None | $128.82 | $128.82 | $128.82 |
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 $70.79 Median $104.71 Typical High $169.82 | Professional | None | $70.79 | $104.71 | $169.82 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $107.15 Median $154.88 Typical High $251.19 | Professional | 50 · Both sides | $107.15 | $154.88 | $251.19 |
CareSource Setting Facility Modifier None Typical Low $75.86 Median $87.10 Typical High $125.89 | Facility | None | $75.86 | $87.10 | $125.89 |
CareSource Setting Professional Modifier None Typical Low $77.62 Median $109.65 Typical High $128.82 | Professional | None | $77.62 | $109.65 | $128.82 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $85.11 Typical High $134.90 | Facility | None | $34.67 | $85.11 | $134.90 |
Cigna Setting Professional Modifier None Typical Low $79.43 Median $131.83 Typical High $851.14 | Professional | None | $79.43 | $131.83 | $851.14 |
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 $95.50 Median $138.04 Typical High $190.55 | Professional | None | $95.50 | $138.04 | $190.55 |
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 $40.74 Median $56.23 Typical High $79.43 | Facility | 52 · Reduced service | $40.74 | $56.23 | $79.43 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $16.22 Median $22.39 Typical High $32.36 | Facility | 53 · Discontinued | $16.22 | $22.39 | $32.36 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $60.26 Median $85.11 Typical High $120.23 | Facility | 54 · Surgery only | $60.26 | $85.11 | $120.23 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $12.02 Median $16.98 Typical High $23.99 | Facility | 55 · Aftercare only | $12.02 | $16.98 | $23.99 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $8.13 Median $11.22 Typical High $16.22 | Facility | 56 · Pre-op care only | $8.13 | $11.22 | $16.22 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $40.74 Median $54.95 Typical High $61.66 | Professional | 52 · Reduced service | $40.74 | $54.95 | $61.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.22 Median $21.88 Typical High $24.55 | Professional | 53 · Discontinued | $16.22 | $21.88 | $24.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $60.26 Median $83.18 Typical High $91.20 | Professional | 54 · Surgery only | $60.26 | $83.18 | $91.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $16.60 Typical High $18.20 | Professional | 55 · Aftercare only | $12.02 | $16.60 | $18.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.13 Median $10.96 Typical High $12.30 | Professional | 56 · Pre-op care only | $8.13 | $10.96 | $12.30 |
Where Kentucky sits
The same service costs 3.2 times more in Wisconsin than in Texas. 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· 49th of 51
$112
WI $363TX $112
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.