How much rates vary
Facilitymedian $832 · 10th to 90th $98 to $2,818Professionalmedian $110 · 10th to 90th $62 to $186
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 $67.61 Median $128.82 Typical High $794.33 | Facility | None | $67.61 | $128.82 | $794.33 |
Aetna Setting Professional Modifier None Typical Low $67.61 Median $128.82 Typical High $194.98 | Professional | None | $67.61 | $128.82 | $194.98 |
Ambetter Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $229.09 | Professional | None | $229.09 | $229.09 | $229.09 |
Anthem BCBS Setting Facility Modifier None Typical Low $588.84 Median $1,698.24 Typical High $2,884.03 | Facility | None | $588.84 | $1,698.24 | $2,884.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $61.66 Median $95.50 Typical High $144.54 | Professional | None | $61.66 | $95.50 | $144.54 |
CareSource Setting Facility Modifier None Typical Low $67.61 Median $97.72 Typical High $169.82 | Facility | None | $67.61 | $97.72 | $169.82 |
CareSource Setting Professional Modifier None Typical Low $87.10 Median $131.83 Typical High $186.21 | Professional | None | $87.10 | $131.83 | $186.21 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $120.23 Typical High $398.11 | Facility | None | $34.67 | $120.23 | $398.11 |
Cigna Setting Professional Modifier None Typical Low $70.79 Median $141.25 Typical High $758.58 | Professional | None | $70.79 | $141.25 | $758.58 |
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 $72.44 Median $128.82 Typical High $204.17 | Professional | None | $72.44 | $128.82 | $204.17 |
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 $33.88 Median $64.57 Typical High $72.44 | Facility | 52 · Reduced service | $33.88 | $64.57 | $72.44 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $13.49 Median $25.70 Typical High $28.84 | Facility | 53 · Discontinued | $13.49 | $25.70 | $28.84 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $50.12 Median $97.72 Typical High $109.65 | Facility | 54 · Surgery only | $50.12 | $97.72 | $109.65 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $10.00 Median $19.50 Typical High $21.88 | Facility | 55 · Aftercare only | $10.00 | $19.50 | $21.88 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $6.76 Median $12.88 Typical High $14.45 | Facility | 56 · Pre-op care only | $6.76 | $12.88 | $14.45 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $33.88 Median $63.10 Typical High $72.44 | Professional | 52 · Reduced service | $33.88 | $63.10 | $72.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.49 Median $25.12 Typical High $28.84 | Professional | 53 · Discontinued | $13.49 | $25.12 | $28.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $50.12 Median $95.50 Typical High $109.65 | Professional | 54 · Surgery only | $50.12 | $95.50 | $109.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $19.05 Typical High $21.88 | Professional | 55 · Aftercare only | $10.00 | $19.05 | $21.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $12.59 Typical High $14.45 | Professional | 56 · Pre-op care only | $6.76 | $12.59 | $14.45 |
Where Kentucky sits
The same service costs 3.3 times more in Wisconsin 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
$112
WI $372KY $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.