How much rates vary
Facilitymedian $117 · 10th to 90th $78 to $1,862Professionalmedian $100 · 10th to 90th $69 to $158
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 $109.65 Typical High $851.14 | Facility | None | $81.28 | $109.65 | $851.14 |
Aetna Setting Professional Modifier None Typical Low $81.28 Median $109.65 Typical High $165.96 | Professional | None | $81.28 | $109.65 | $165.96 |
Ambetter Setting Professional Modifier None Typical Low $107.15 Median $147.91 Typical High $147.91 | Professional | None | $107.15 | $147.91 | $147.91 |
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 $67.61 Median $87.10 Typical High $128.82 | Professional | None | $67.61 | $87.10 | $128.82 |
CareSource Setting Facility Modifier None Typical Low $81.28 Median $95.50 Typical High $134.90 | Facility | None | $81.28 | $95.50 | $134.90 |
CareSource Setting Professional Modifier None Typical Low $104.71 Median $117.49 Typical High $162.18 | Professional | None | $104.71 | $117.49 | $162.18 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $79.43 Typical High $398.11 | Facility | None | $34.67 | $79.43 | $398.11 |
Cigna Setting Professional Modifier None Typical Low $87.10 Median $125.89 Typical High $630.96 | Professional | None | $87.10 | $125.89 | $630.96 |
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 $89.13 Median $131.83 Typical High $190.55 | Professional | None | $89.13 | $131.83 | $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 $54.95 Typical High $61.66 | Facility | 52 · Reduced service | $40.74 | $54.95 | $61.66 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $16.22 Median $21.88 Typical High $25.12 | Facility | 53 · Discontinued | $16.22 | $21.88 | $25.12 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $61.66 Median $83.18 Typical High $93.33 | Facility | 54 · Surgery only | $61.66 | $83.18 | $93.33 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $12.30 Median $16.60 Typical High $18.62 | Facility | 55 · Aftercare only | $12.30 | $16.60 | $18.62 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $8.13 Median $10.96 Typical High $12.30 | Facility | 56 · Pre-op care only | $8.13 | $10.96 | $12.30 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $40.74 Median $53.70 Typical High $61.66 | Professional | 52 · Reduced service | $40.74 | $53.70 | $61.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.22 Median $21.88 Typical High $25.12 | Professional | 53 · Discontinued | $16.22 | $21.88 | $25.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $61.66 Median $81.28 Typical High $93.33 | Professional | 54 · Surgery only | $61.66 | $81.28 | $93.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $16.22 Typical High $18.62 | Professional | 55 · Aftercare only | $12.30 | $16.22 | $18.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.13 Median $10.72 Typical High $12.30 | Professional | 56 · Pre-op care only | $8.13 | $10.72 | $12.30 |
Where Kentucky sits
The same service costs 3.7 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
$100
AK $372KY $100
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.