How much rates vary
Facilitymedian $269 · 10th to 90th $100 to $3,311Professionalmedian $204 · 10th to 90th $132 to $457
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 $131.83 Median $269.15 Typical High $933.25 | Facility | None | $131.83 | $269.15 | $933.25 |
Aetna Setting Professional Modifier None Typical Low $131.83 Median $269.15 Typical High $380.19 | Professional | None | $131.83 | $269.15 | $380.19 |
Ambetter Setting Professional Modifier None Typical Low $346.74 Median $346.74 Typical High $346.74 | Professional | None | $346.74 | $346.74 | $346.74 |
Anthem BCBS Setting Facility Modifier None Typical Low $912.01 Median $2,570.40 Typical High $11,220.18 | Facility | None | $912.01 | $2,570.40 | $11,220.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $123.03 Median $141.25 Typical High $398.11 | Professional | None | $123.03 | $141.25 | $398.11 |
CareSource Setting Facility Modifier None Typical Low $123.03 Median $147.91 Typical High $234.42 | Facility | None | $123.03 | $147.91 | $234.42 |
CareSource Setting Professional Modifier None Typical Low $144.54 Median $204.17 Typical High $239.88 | Professional | None | $144.54 | $204.17 | $239.88 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $251.19 Typical High $251.19 | Facility | None | $34.67 | $251.19 | $251.19 |
Cigna Setting Professional Modifier None Typical Low $147.91 Median $316.23 Typical High $1,995.26 | Professional | None | $147.91 | $316.23 | $1,995.26 |
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 $50.12 Median $416.87 Typical High $1,949.84 | Facility | None | $50.12 | $416.87 | $1,949.84 |
United Setting Professional Modifier None Typical Low $177.83 Median $323.59 Typical High $489.78 | Professional | None | $177.83 | $323.59 | $489.78 |
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 $64.57 Median $134.90 Typical High $186.21 | Facility | 52 · Reduced service | $64.57 | $134.90 | $186.21 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $26.30 Median $53.70 Typical High $75.86 | Facility | 53 · Discontinued | $26.30 | $53.70 | $75.86 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $97.72 Median $204.17 Typical High $281.84 | Facility | 54 · Surgery only | $97.72 | $204.17 | $281.84 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $19.50 Median $40.74 Typical High $56.23 | Facility | 55 · Aftercare only | $19.50 | $40.74 | $56.23 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $13.18 Median $26.92 Typical High $38.02 | Facility | 56 · Pre-op care only | $13.18 | $26.92 | $38.02 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $64.57 Median $134.90 Typical High $186.21 | Professional | 52 · Reduced service | $64.57 | $134.90 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $53.70 Typical High $74.13 | Professional | 53 · Discontinued | $26.30 | $53.70 | $74.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $97.72 Median $204.17 Typical High $281.84 | Professional | 54 · Surgery only | $97.72 | $204.17 | $281.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $40.74 Typical High $56.23 | Professional | 55 · Aftercare only | $19.50 | $40.74 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $26.92 Typical High $37.15 | Professional | 56 · Pre-op care only | $13.18 | $26.92 | $37.15 |
Where Kentucky sits
The same service costs 3.3 times more in Alaska than in 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.
Kentucky· 50th of 51
$209
AK $676VA $204
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.