How much rates vary
Facilitymedian $1,259 · 10th to 90th $115 to $2,884Professionalmedian $141 · 10th to 90th $76 to $347
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 $97.72 Median $199.53 Typical High $436.52 | Facility | None | $97.72 | $199.53 | $436.52 |
Aetna Setting Professional Modifier None Typical Low $97.72 Median $199.53 Typical High $275.42 | Professional | None | $97.72 | $199.53 | $275.42 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,071.52 Median $2,041.74 Typical High $3,019.95 | Facility | None | $1,071.52 | $2,041.74 | $3,019.95 |
Anthem BCBS Setting Professional Modifier None Typical Low $66.07 Median $77.62 Typical High $165.96 | Professional | None | $66.07 | $77.62 | $165.96 |
CareSource Setting Facility Modifier None Typical Low $93.33 Median $112.20 Typical High $173.78 | Facility | None | $93.33 | $112.20 | $173.78 |
CareSource Setting Professional Modifier None Typical Low $107.15 Median $147.91 Typical High $173.78 | Professional | None | $107.15 | $147.91 | $173.78 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $181.97 Typical High $181.97 | Facility | None | $34.67 | $181.97 | $181.97 |
Cigna Setting Professional Modifier None Typical Low $112.20 Median $239.88 Typical High $1,174.90 | Professional | None | $112.20 | $239.88 | $1,174.90 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $104.71 | Professional | None | $33.11 | $33.11 | $104.71 |
United Setting Facility Modifier None Typical Low $389.05 Median $831.76 Typical High $2,630.27 | Facility | None | $389.05 | $831.76 | $2,630.27 |
United Setting Professional Modifier None Typical Low $138.04 Median $245.47 Typical High $354.81 | Professional | None | $138.04 | $245.47 | $354.81 |
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 $48.98 Median $97.72 Typical High $181.97 | Facility | 52 · Reduced service | $48.98 | $97.72 | $181.97 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $19.50 Median $38.90 Typical High $72.44 | Facility | 53 · Discontinued | $19.50 | $38.90 | $72.44 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $74.13 Median $147.91 Typical High $269.15 | Facility | 54 · Surgery only | $74.13 | $147.91 | $269.15 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $14.79 Median $29.51 Typical High $54.95 | Facility | 55 · Aftercare only | $14.79 | $29.51 | $54.95 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $9.77 Median $19.50 Typical High $36.31 | Facility | 56 · Pre-op care only | $9.77 | $19.50 | $36.31 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $48.98 Median $97.72 Typical High $138.04 | Professional | 52 · Reduced service | $48.98 | $97.72 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.50 Median $38.90 Typical High $54.95 | Professional | 53 · Discontinued | $19.50 | $38.90 | $54.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $74.13 Median $147.91 Typical High $208.93 | Professional | 54 · Surgery only | $74.13 | $147.91 | $208.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.79 Median $29.51 Typical High $40.74 | Professional | 55 · Aftercare only | $14.79 | $29.51 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.77 Median $19.50 Typical High $27.54 | Professional | 56 · Pre-op care only | $9.77 | $19.50 | $27.54 |
Where Kentucky sits
The same service costs 3.4 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
$158
AK $525VA $155
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.