How much rates vary
Facilitymedian $1,995 · 10th to 90th $112 to $8,318Professionalmedian $141 · 10th to 90th $95 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 $426.58 | Facility | None | $97.72 | $199.53 | $426.58 |
Aetna Setting Professional Modifier None Typical Low $97.72 Median $199.53 Typical High $295.12 | Professional | None | $97.72 | $199.53 | $295.12 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,949.84 Median $3,467.37 Typical High $8,709.64 | Facility | None | $1,949.84 | $3,467.37 | $8,709.64 |
Anthem BCBS Setting Professional Modifier None Typical Low $87.10 Median $102.33 Typical High $162.18 | Professional | None | $87.10 | $102.33 | $162.18 |
CareSource Setting Facility Modifier None Typical Low $91.20 Median $109.65 Typical High $173.78 | Facility | None | $91.20 | $109.65 | $173.78 |
CareSource Setting Professional Modifier None Typical Low $107.15 Median $151.36 Typical High $177.83 | Professional | None | $107.15 | $151.36 | $177.83 |
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 $109.65 Median $234.42 Typical High $1,174.90 | Professional | None | $109.65 | $234.42 | $1,174.90 |
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 $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 $134.90 Median $239.88 Typical High $354.81 | Professional | None | $134.90 | $239.88 | $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 $95.50 Typical High $177.83 | Facility | 52 · Reduced service | $48.98 | $95.50 | $177.83 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $19.50 Median $38.90 Typical High $70.79 | Facility | 53 · Discontinued | $19.50 | $38.90 | $70.79 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $72.44 Median $144.54 Typical High $269.15 | Facility | 54 · Surgery only | $72.44 | $144.54 | $269.15 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $14.45 Median $28.84 Typical High $53.70 | Facility | 55 · Aftercare only | $14.45 | $28.84 | $53.70 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $9.77 Median $19.05 Typical High $35.48 | Facility | 56 · Pre-op care only | $9.77 | $19.05 | $35.48 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $48.98 Median $97.72 Typical High $134.90 | Professional | 52 · Reduced service | $48.98 | $97.72 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.50 Median $38.90 Typical High $53.70 | Professional | 53 · Discontinued | $19.50 | $38.90 | $53.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $72.44 Median $144.54 Typical High $204.17 | Professional | 54 · Surgery only | $72.44 | $144.54 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.45 Median $28.84 Typical High $40.74 | Professional | 55 · Aftercare only | $14.45 | $28.84 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.77 Median $19.50 Typical High $26.92 | Professional | 56 · Pre-op care only | $9.77 | $19.50 | $26.92 |
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
$155
AK $513VA $151
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.