How much rates vary
Facilitymedian $1,259 · 10th to 90th $115 to $2,884Professionalmedian $141 · 10th to 90th $98 to $355
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 $204.17 Typical High $794.33 | Facility | None | $97.72 | $204.17 | $794.33 |
Aetna Setting Professional Modifier None Typical Low $97.72 Median $204.17 Typical High $288.40 | Professional | None | $97.72 | $204.17 | $288.40 |
Ambetter Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $120.23 | Professional | None | $120.23 | $120.23 | $120.23 |
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 $89.13 Median $104.71 Typical High $165.96 | Professional | None | $89.13 | $104.71 | $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 $120.23 Median $154.88 Typical High $181.97 | Professional | None | $120.23 | $154.88 | $181.97 |
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 $245.47 Typical High $1,202.26 | Professional | None | $112.20 | $245.47 | $1,202.26 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $107.15 | Professional | None | $33.11 | $33.11 | $107.15 |
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 $251.19 Typical High $371.54 | Professional | None | $138.04 | $251.19 | $371.54 |
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 $100.00 Typical High $186.21 | Facility | 52 · Reduced service | $48.98 | $100.00 | $186.21 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $19.50 Median $39.81 Typical High $75.86 | Facility | 53 · Discontinued | $19.50 | $39.81 | $75.86 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $74.13 Median $147.91 Typical High $281.84 | Facility | 54 · Surgery only | $74.13 | $147.91 | $281.84 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $14.79 Median $29.51 Typical High $56.23 | Facility | 55 · Aftercare only | $14.79 | $29.51 | $56.23 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $9.77 Median $19.95 Typical High $37.15 | Facility | 56 · Pre-op care only | $9.77 | $19.95 | $37.15 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $48.98 Median $100.00 Typical High $138.04 | Professional | 52 · Reduced service | $48.98 | $100.00 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.50 Median $39.81 Typical High $56.23 | Professional | 53 · Discontinued | $19.50 | $39.81 | $56.23 |
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 $30.20 Typical High $41.69 | Professional | 55 · Aftercare only | $14.79 | $30.20 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.77 Median $19.95 Typical High $27.54 | Professional | 56 · Pre-op care only | $9.77 | $19.95 | $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.