How much rates vary
Facilitymedian $245 · 10th to 90th $100 to $3,311Professionalmedian $209 · 10th to 90th $135 to $437
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 $120.23 Median $245.47 Typical High $851.14 | Facility | None | $120.23 | $245.47 | $851.14 |
Aetna Setting Professional Modifier None Typical Low $120.23 Median $245.47 Typical High $380.19 | Professional | None | $120.23 | $245.47 | $380.19 |
Anthem BCBS Setting Facility Modifier None Typical Low $9,120.11 Median $10,715.19 Typical High $11,220.18 | Facility | None | $9,120.11 | $10,715.19 | $11,220.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $138.04 Median $169.82 Typical High $251.19 | Professional | None | $138.04 | $169.82 | $251.19 |
CareSource Setting Facility Modifier None Typical Low $112.20 Median $134.90 Typical High $213.80 | Facility | None | $112.20 | $134.90 | $213.80 |
CareSource Setting Professional Modifier None Typical Low $144.54 Median $186.21 Typical High $218.78 | Professional | None | $144.54 | $186.21 | $218.78 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $239.88 Typical High $239.88 | Facility | None | $34.67 | $239.88 | $239.88 |
Cigna Setting Professional Modifier None Typical Low $134.90 Median $309.03 Typical High $2,089.30 | Professional | None | $134.90 | $309.03 | $2,089.30 |
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 $169.82 Median $316.23 Typical High $446.68 | Professional | None | $169.82 | $316.23 | $446.68 |
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 $60.26 Median $120.23 Typical High $194.98 | Facility | 52 · Reduced service | $60.26 | $120.23 | $194.98 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $23.99 Median $48.98 Typical High $79.43 | Facility | 53 · Discontinued | $23.99 | $48.98 | $79.43 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $89.13 Median $181.97 Typical High $295.12 | Facility | 54 · Surgery only | $89.13 | $181.97 | $295.12 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $17.78 Median $36.31 Typical High $58.88 | Facility | 55 · Aftercare only | $17.78 | $36.31 | $58.88 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $12.02 Median $24.55 Typical High $39.81 | Facility | 56 · Pre-op care only | $12.02 | $24.55 | $39.81 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $60.26 Median $120.23 Typical High $177.83 | Professional | 52 · Reduced service | $60.26 | $120.23 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $48.98 Typical High $72.44 | Professional | 53 · Discontinued | $23.99 | $48.98 | $72.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $89.13 Median $181.97 Typical High $269.15 | Professional | 54 · Surgery only | $89.13 | $181.97 | $269.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $36.31 Typical High $53.70 | Professional | 55 · Aftercare only | $17.78 | $36.31 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $24.55 Typical High $36.31 | Professional | 56 · Pre-op care only | $12.02 | $24.55 | $36.31 |
Where Kentucky sits
The same service costs 3.5 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· 48th of 51
$214
AK $661VA $186
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.