How much rates vary
Facilitymedian $741 · 10th to 90th $135 to $2,818Professionalmedian $135 · 10th to 90th $91 to $229
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 $95.50 Median $158.49 Typical High $416.87 | Facility | None | $95.50 | $158.49 | $416.87 |
Aetna Setting Professional Modifier None Typical Low $95.50 Median $134.90 Typical High $186.21 | Professional | None | $95.50 | $134.90 | $186.21 |
Ambetter Setting Professional Modifier None Typical Low $100.00 Median $100.00 Typical High $100.00 | Professional | None | $100.00 | $100.00 | $100.00 |
Anthem BCBS Setting Facility Modifier None Typical Low $190.55 Median $1,698.24 Typical High $2,884.03 | Facility | None | $190.55 | $1,698.24 | $2,884.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $91.20 Median $107.15 Typical High $190.55 | Professional | None | $91.20 | $107.15 | $190.55 |
CareSource Setting Facility Modifier None Typical Low $102.33 Median $169.82 Typical High $630.96 | Facility | None | $102.33 | $169.82 | $630.96 |
CareSource Setting Professional Modifier None Typical Low $102.33 Median $138.04 Typical High $169.82 | Professional | None | $102.33 | $138.04 | $169.82 |
Cigna Setting Facility Modifier None Typical Low $181.97 Median $446.68 Typical High $1,318.26 | Facility | None | $181.97 | $446.68 | $1,318.26 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $158.49 Typical High $870.96 | Professional | None | $107.15 | $158.49 | $870.96 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $77.62 | Professional | None | $33.11 | $33.11 | $77.62 |
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 $114.82 Median $162.18 Typical High $234.42 | Professional | None | $114.82 | $162.18 | $234.42 |
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 $46.77 Median $67.61 Typical High $83.18 | Facility | 52 · Reduced service | $46.77 | $67.61 | $83.18 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $19.05 Median $26.92 Typical High $33.88 | Facility | 53 · Discontinued | $19.05 | $26.92 | $33.88 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $70.79 Median $102.33 Typical High $125.89 | Facility | 54 · Surgery only | $70.79 | $102.33 | $125.89 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $14.13 Median $20.42 Typical High $25.12 | Facility | 55 · Aftercare only | $14.13 | $20.42 | $25.12 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $9.33 Median $13.49 Typical High $16.98 | Facility | 56 · Pre-op care only | $9.33 | $13.49 | $16.98 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $46.77 Median $67.61 Typical High $79.43 | Professional | 52 · Reduced service | $46.77 | $67.61 | $79.43 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.05 Median $26.92 Typical High $31.62 | Professional | 53 · Discontinued | $19.05 | $26.92 | $31.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $70.79 Median $102.33 Typical High $120.23 | Professional | 54 · Surgery only | $70.79 | $102.33 | $120.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.13 Median $20.42 Typical High $23.99 | Professional | 55 · Aftercare only | $14.13 | $20.42 | $23.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.33 Median $13.49 Typical High $15.85 | Professional | 56 · Pre-op care only | $9.33 | $13.49 | $15.85 |
Where Kentucky sits
The same service costs 6.3 times more in New York than in Montana. 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
NY $2,712MT $427
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.