How much rates vary
Facilitymedian $1,413 · 10th to 90th $324 to $3,981Professionalmedian $427 · 10th to 90th $251 to $646
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 $257.04 Median $354.81 Typical High $851.14 | Facility | None | $257.04 | $354.81 | $851.14 |
Aetna Setting Professional Modifier None Typical Low $251.19 Median $346.74 Typical High $457.09 | Professional | None | $251.19 | $346.74 | $457.09 |
Ambetter Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $316.23 | Professional | None | $316.23 | $316.23 | $316.23 |
Anthem BCBS Setting Facility Modifier None Typical Low $724.44 Median $1,995.26 Typical High $4,265.80 | Facility | None | $724.44 | $1,995.26 | $4,265.80 |
Anthem BCBS Setting Professional Modifier None Typical Low $234.42 Median $426.58 Typical High $562.34 | Professional | None | $234.42 | $426.58 | $562.34 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $144.54 Median $269.15 Typical High $354.81 | Professional | 62 · Two surgeons | $144.54 | $269.15 | $354.81 |
CareSource Setting Facility Modifier None Typical Low $229.09 Median $426.58 Typical High $3,715.35 | Facility | None | $229.09 | $426.58 | $3,715.35 |
CareSource Setting Professional Modifier None Typical Low $239.88 Median $371.54 Typical High $436.52 | Professional | None | $239.88 | $371.54 | $436.52 |
Cigna Setting Facility Modifier None Typical Low $426.58 Median $1,659.59 Typical High $2,754.23 | Facility | None | $426.58 | $1,659.59 | $2,754.23 |
Cigna Setting Professional Modifier None Typical Low $269.15 Median $489.78 Typical High $2,398.83 | Professional | None | $269.15 | $489.78 | $2,398.83 |
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 $323.59 Median $588.84 Typical High $1,995.26 | Facility | None | $323.59 | $588.84 | $1,995.26 |
United Setting Professional Modifier None Typical Low $263.03 Median $446.68 Typical High $660.69 | Professional | None | $263.03 | $446.68 | $660.69 |
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 $128.82 Median $177.83 Typical High $229.09 | Facility | 52 · Reduced service | $128.82 | $177.83 | $229.09 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $51.29 Median $70.79 Typical High $93.33 | Facility | 53 · Discontinued | $51.29 | $70.79 | $93.33 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $194.98 Median $263.03 Typical High $346.74 | Facility | 54 · Surgery only | $194.98 | $263.03 | $346.74 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $38.90 Median $53.70 Typical High $69.18 | Facility | 55 · Aftercare only | $38.90 | $53.70 | $69.18 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $25.70 Median $35.48 Typical High $45.71 | Facility | 56 · Pre-op care only | $25.70 | $35.48 | $45.71 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $128.82 Median $173.78 Typical High $199.53 | Professional | 52 · Reduced service | $128.82 | $173.78 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $69.18 Typical High $79.43 | Professional | 53 · Discontinued | $51.29 | $69.18 | $79.43 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $263.03 Typical High $302.00 | Professional | 54 · Surgery only | $194.98 | $263.03 | $302.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $52.48 Typical High $60.26 | Professional | 55 · Aftercare only | $38.90 | $52.48 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $34.67 Typical High $39.81 | Professional | 56 · Pre-op care only | $25.70 | $34.67 | $39.81 |
Where Kentucky sits
The same service costs 3.9 times more in Alaska than in New York. 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· 38th of 51
$427
AK $1,380NY $355
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.