How much rates vary
Facilitymedian $100 · 10th to 90th $29 to $1,479Professionalmedian $35 · 10th to 90th $25 to $81
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 $25.70 Median $37.15 Typical High $851.14 | Facility | None | $25.70 | $37.15 | $851.14 |
Aetna Setting Professional Modifier None Typical Low $25.70 Median $33.11 Typical High $57.54 | Professional | None | $25.70 | $33.11 | $57.54 |
Ambetter Setting Professional Modifier None Typical Low $47.86 Median $47.86 Typical High $47.86 | Professional | None | $47.86 | $47.86 | $47.86 |
Anthem BCBS Setting Facility Modifier None Typical Low $758.58 Median $9,549.93 Typical High $11,220.18 | Facility | None | $758.58 | $9,549.93 | $11,220.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $25.12 Median $31.62 Typical High $83.18 | Professional | None | $25.12 | $31.62 | $83.18 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $15.85 Median $20.42 Typical High $51.29 | Professional | 62 · Two surgeons | $15.85 | $20.42 | $51.29 |
CareSource Setting Facility Modifier None Typical Low $25.70 Median $794.33 Typical High $1,445.44 | Facility | None | $25.70 | $794.33 | $1,445.44 |
CareSource Setting Professional Modifier None Typical Low $24.55 Median $37.15 Typical High $43.65 | Professional | None | $24.55 | $37.15 | $43.65 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $45.71 Typical High $363.08 | Facility | None | $34.67 | $45.71 | $363.08 |
Cigna Setting Professional Modifier None Typical Low $27.54 Median $43.65 Typical High $512.86 | Professional | None | $27.54 | $43.65 | $512.86 |
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 $29.51 Median $45.71 Typical High $64.57 | Professional | None | $29.51 | $45.71 | $64.57 |
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 $12.88 Median $16.60 Typical High $47.86 | Facility | 52 · Reduced service | $12.88 | $16.60 | $47.86 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $5.13 Median $6.61 Typical High $19.50 | Facility | 53 · Discontinued | $5.13 | $6.61 | $19.50 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $19.50 Median $25.12 Typical High $72.44 | Facility | 54 · Surgery only | $19.50 | $25.12 | $72.44 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $3.89 Median $5.01 Typical High $14.45 | Facility | 55 · Aftercare only | $3.89 | $5.01 | $14.45 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $2.57 Median $3.31 Typical High $9.55 | Facility | 56 · Pre-op care only | $2.57 | $3.31 | $9.55 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $12.88 Median $16.22 Typical High $18.62 | Professional | 52 · Reduced service | $12.88 | $16.22 | $18.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.13 Median $6.46 Typical High $7.41 | Professional | 53 · Discontinued | $5.13 | $6.46 | $7.41 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $19.50 Median $24.55 Typical High $28.18 | Professional | 54 · Surgery only | $19.50 | $24.55 | $28.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.89 Median $4.90 Typical High $5.62 | Professional | 55 · Aftercare only | $3.89 | $4.90 | $5.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.57 Median $3.24 Typical High $3.72 | Professional | 56 · Pre-op care only | $2.57 | $3.24 | $3.72 |
Where Kentucky sits
The same service costs 3.3 times more in Alaska 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
$35.48
AK $117KY $35.48
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.