How much rates vary
Facilitymedian $229 · 10th to 90th $63 to $2,239Professionalmedian $95 · 10th to 90th $68 to $162
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 $70.79 Median $100.00 Typical High $851.14 | Facility | None | $70.79 | $100.00 | $851.14 |
Aetna Setting Professional Modifier None Typical Low $70.79 Median $100.00 Typical High $117.49 | Professional | None | $70.79 | $100.00 | $117.49 |
Ambetter Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $104.71 | Professional | None | $104.71 | $104.71 | $104.71 |
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 $66.07 Median $85.11 Typical High $162.18 | Professional | None | $66.07 | $85.11 | $162.18 |
CareSource Setting Facility Modifier None Typical Low $67.61 Median $72.44 Typical High $112.20 | Facility | None | $67.61 | $72.44 | $112.20 |
CareSource Setting Professional Modifier None Typical Low $64.57 Median $97.72 Typical High $117.49 | Professional | None | $64.57 | $97.72 | $117.49 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $61.66 Typical High $398.11 | Facility | None | $34.67 | $61.66 | $398.11 |
Cigna Setting Professional Modifier None Typical Low $72.44 Median $123.03 Typical High $977.24 | Professional | None | $72.44 | $123.03 | $977.24 |
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 $77.62 Median $109.65 Typical High $173.78 | Professional | None | $77.62 | $109.65 | $173.78 |
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 $35.48 Median $50.12 Typical High $91.20 | Facility | 52 · Reduced service | $35.48 | $50.12 | $91.20 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $14.13 Median $19.95 Typical High $36.31 | Facility | 53 · Discontinued | $14.13 | $19.95 | $36.31 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $52.48 Median $74.13 Typical High $138.04 | Facility | 54 · Surgery only | $52.48 | $74.13 | $138.04 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $10.47 Median $14.79 Typical High $27.54 | Facility | 55 · Aftercare only | $10.47 | $14.79 | $27.54 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $7.08 Median $10.00 Typical High $18.20 | Facility | 56 · Pre-op care only | $7.08 | $10.00 | $18.20 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $35.48 Median $50.12 Typical High $52.48 | Professional | 52 · Reduced service | $35.48 | $50.12 | $52.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.13 Median $19.95 Typical High $20.89 | Professional | 53 · Discontinued | $14.13 | $19.95 | $20.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $52.48 Median $74.13 Typical High $77.62 | Professional | 54 · Surgery only | $52.48 | $74.13 | $77.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $14.79 Typical High $15.49 | Professional | 55 · Aftercare only | $10.47 | $14.79 | $15.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.08 Median $10.00 Typical High $10.47 | Professional | 56 · Pre-op care only | $7.08 | $10.00 | $10.47 |
Where Kentucky sits
The same service costs 12.3 times more in Connecticut than in West Virginia. 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 $2,823WV $230
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.