How much rates vary
Facilitymedian $110 · 10th to 90th $56 to $1,778Professionalmedian $56 · 10th to 90th $39 to $117
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 $56.23 Median $107.15 Typical High $851.14 | Facility | None | $56.23 | $107.15 | $851.14 |
Aetna Setting Professional Modifier None Typical Low $46.77 Median $81.28 Typical High $123.03 | Professional | None | $46.77 | $81.28 | $123.03 |
Ambetter Setting Professional Modifier None Typical Low $46.77 Median $64.57 Typical High $77.62 | Professional | None | $46.77 | $64.57 | $77.62 |
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 $37.15 Median $46.77 Typical High $66.07 | Professional | None | $37.15 | $46.77 | $66.07 |
CareSource Setting Facility Modifier None Typical Low $58.88 Median $100.00 Typical High $131.83 | Facility | None | $58.88 | $100.00 | $131.83 |
CareSource Setting Professional Modifier None Typical Low $56.23 Median $85.11 Typical High $102.33 | Professional | None | $56.23 | $85.11 | $102.33 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $93.33 Typical High $398.11 | Facility | None | $34.67 | $93.33 | $398.11 |
Cigna Setting Professional Modifier None Typical Low $42.66 Median $95.50 Typical High $630.96 | Professional | None | $42.66 | $95.50 | $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 $43.65 Median $72.44 Typical High $123.03 | Professional | None | $43.65 | $72.44 | $123.03 |
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 $28.18 Median $50.12 Typical High $60.26 | Facility | 52 · Reduced service | $28.18 | $50.12 | $60.26 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $11.48 Median $19.95 Typical High $23.99 | Facility | 53 · Discontinued | $11.48 | $19.95 | $23.99 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $42.66 Median $74.13 Typical High $91.20 | Facility | 54 · Surgery only | $42.66 | $74.13 | $91.20 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $8.51 Median $14.79 Typical High $18.20 | Facility | 55 · Aftercare only | $8.51 | $14.79 | $18.20 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $5.75 Median $10.00 Typical High $12.02 | Facility | 56 · Pre-op care only | $5.75 | $10.00 | $12.02 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $21.38 Median $40.74 Typical High $60.26 | Professional | 52 · Reduced service | $21.38 | $40.74 | $60.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.71 Median $16.22 Typical High $23.99 | Professional | 53 · Discontinued | $8.71 | $16.22 | $23.99 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $32.36 Median $60.26 Typical High $91.20 | Professional | 54 · Surgery only | $32.36 | $60.26 | $91.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.46 Median $12.30 Typical High $18.20 | Professional | 55 · Aftercare only | $6.46 | $12.30 | $18.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $8.13 Typical High $12.02 | Professional | 56 · Pre-op care only | $4.37 | $8.13 | $12.02 |
Where Kentucky sits
The same service costs 16.4 times more in Connecticut 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.
Physician feeFacility fee
CT $2,728KY $166
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.