How much rates vary
Facilitymedian $741 · 10th to 90th $54 to $2,818Professionalmedian $76 · 10th to 90th $47 to $126
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 $45.71 Median $93.33 Typical High $416.87 | Facility | None | $45.71 | $93.33 | $416.87 |
Aetna Setting Professional Modifier None Typical Low $45.71 Median $91.20 Typical High $131.83 | Professional | None | $45.71 | $91.20 | $131.83 |
Ambetter Setting Professional Modifier None Typical Low $66.07 Median $97.72 Typical High $138.04 | Professional | None | $66.07 | $97.72 | $138.04 |
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 $46.77 Median $72.44 Typical High $125.89 | Professional | None | $46.77 | $72.44 | $125.89 |
CareSource Setting Facility Modifier None Typical Low $45.71 Median $1,548.82 Typical High $2,818.38 | Facility | None | $45.71 | $1,548.82 | $2,818.38 |
CareSource Setting Professional Modifier None Typical Low $58.88 Median $95.50 Typical High $134.90 | Professional | None | $58.88 | $95.50 | $134.90 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $75.86 Typical High $77.62 | Facility | None | $34.67 | $75.86 | $77.62 |
Cigna Setting Professional Modifier None Typical Low $47.86 Median $100.00 Typical High $512.86 | Professional | None | $47.86 | $100.00 | $512.86 |
Molina Setting Professional Modifier None Typical Low $46.77 Median $58.88 Typical High $70.79 | Professional | None | $46.77 | $58.88 | $70.79 |
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 $52.48 Median $81.28 Typical High $131.83 | Professional | None | $52.48 | $81.28 | $131.83 |
12 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 $22.91 Median $46.77 Typical High $53.70 | Facility | 52 · Reduced service | $22.91 | $46.77 | $53.70 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $9.12 Median $18.62 Typical High $21.38 | Facility | 53 · Discontinued | $9.12 | $18.62 | $21.38 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $33.88 Median $70.79 Typical High $81.28 | Facility | 54 · Surgery only | $33.88 | $70.79 | $81.28 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $6.76 Median $14.13 Typical High $16.22 | Facility | 55 · Aftercare only | $6.76 | $14.13 | $16.22 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $4.57 Median $9.33 Typical High $10.72 | Facility | 56 · Pre-op care only | $4.57 | $9.33 | $10.72 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $22.91 Median $45.71 Typical High $52.48 | Professional | 52 · Reduced service | $22.91 | $45.71 | $52.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.12 Median $18.20 Typical High $20.89 | Professional | 53 · Discontinued | $9.12 | $18.20 | $20.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $33.88 Median $69.18 Typical High $79.43 | Professional | 54 · Surgery only | $33.88 | $69.18 | $79.43 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.76 Median $13.80 Typical High $15.85 | Professional | 55 · Aftercare only | $6.76 | $13.80 | $15.85 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.57 Median $9.12 Typical High $10.47 | Professional | 56 · Pre-op care only | $4.57 | $9.12 | $10.47 |
Ambetter Setting Professional Modifier 51 · Multiple procedures Typical Low $26.92 Median $41.69 Typical High $51.29 | Professional | 51 · Multiple procedures | $26.92 | $41.69 | $51.29 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $97.72 Median $97.72 Typical High $97.72 | Professional | 59 · Distinct service | $97.72 | $97.72 | $97.72 |
Where Kentucky sits
The same service costs 3.2 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· 50th of 51
$77.62
AK $251NY $77.62
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.