How much rates vary
Facilitymedian $72 · 10th to 90th $42 to $1,148Professionalmedian $68 · 10th to 90th $43 to $110
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 $41.69 Median $64.57 Typical High $114.82 | Facility | None | $41.69 | $64.57 | $114.82 |
Aetna Setting Professional Modifier None Typical Low $41.69 Median $64.57 Typical High $100.00 | Professional | None | $41.69 | $64.57 | $100.00 |
Ambetter Setting Professional Modifier None Typical Low $61.66 Median $77.62 Typical High $89.13 | Professional | None | $61.66 | $77.62 | $89.13 |
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 $42.66 Median $67.61 Typical High $109.65 | Professional | None | $42.66 | $67.61 | $109.65 |
CareSource Setting Facility Modifier None Typical Low $41.69 Median $51.29 Typical High $69.18 | Facility | None | $41.69 | $51.29 | $69.18 |
CareSource Setting Professional Modifier None Typical Low $46.77 Median $60.26 Typical High $70.79 | Professional | None | $46.77 | $60.26 | $70.79 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $42.66 Typical High $72.44 | Facility | None | $34.67 | $42.66 | $72.44 |
Cigna Setting Professional Modifier None Typical Low $43.65 Median $77.62 Typical High $478.63 | Professional | None | $43.65 | $77.62 | $478.63 |
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 $47.86 Median $74.13 Typical High $117.49 | Professional | None | $47.86 | $74.13 | $117.49 |
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 $20.89 Median $32.36 Typical High $44.67 | Facility | 52 · Reduced service | $20.89 | $32.36 | $44.67 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $8.32 Median $12.88 Typical High $18.20 | Facility | 53 · Discontinued | $8.32 | $12.88 | $18.20 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $30.90 Median $48.98 Typical High $67.61 | Facility | 54 · Surgery only | $30.90 | $48.98 | $67.61 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $6.31 Median $9.77 Typical High $13.49 | Facility | 55 · Aftercare only | $6.31 | $9.77 | $13.49 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $4.17 Median $6.46 Typical High $8.91 | Facility | 56 · Pre-op care only | $4.17 | $6.46 | $8.91 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $20.89 Median $31.62 Typical High $36.31 | Professional | 52 · Reduced service | $20.89 | $31.62 | $36.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.32 Median $12.59 Typical High $14.45 | Professional | 53 · Discontinued | $8.32 | $12.59 | $14.45 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $30.90 Median $47.86 Typical High $54.95 | Professional | 54 · Surgery only | $30.90 | $47.86 | $54.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.31 Median $9.55 Typical High $10.96 | Professional | 55 · Aftercare only | $6.31 | $9.55 | $10.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.17 Median $6.31 Typical High $7.24 | Professional | 56 · Pre-op care only | $4.17 | $6.31 | $7.24 |
Where Kentucky sits
The same service costs 3.1 times more in Wisconsin than in Washington, DC. 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· 47th of 51
$67.61
WI $200DC $64.57
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.