How much rates vary
Facilitymedian $832 · 10th to 90th $107 to $2,818Professionalmedian $107 · 10th to 90th $71 to $209
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 $66.07 Median $114.82 Typical High $794.33 | Facility | None | $66.07 | $114.82 | $794.33 |
Aetna Setting Professional Modifier None Typical Low $66.07 Median $107.15 Typical High $162.18 | Professional | None | $66.07 | $107.15 | $162.18 |
Anthem BCBS Setting Facility Modifier None Typical Low $562.34 Median $1,698.24 Typical High $2,884.03 | Facility | None | $562.34 | $1,698.24 | $2,884.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $70.79 Median $85.11 Typical High $102.33 | Professional | None | $70.79 | $85.11 | $102.33 |
CareSource Setting Facility Modifier None Typical Low $70.79 Median $102.33 Typical High $812.83 | Facility | None | $70.79 | $102.33 | $812.83 |
CareSource Setting Professional Modifier None Typical Low $102.33 Median $120.23 Typical High $165.96 | Professional | None | $102.33 | $120.23 | $165.96 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $524.81 Typical High $691.83 | Facility | None | $34.67 | $524.81 | $691.83 |
Cigna Setting Professional Modifier None Typical Low $75.86 Median $125.89 Typical High $707.95 | Professional | None | $75.86 | $125.89 | $707.95 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $91.20 | Professional | None | $33.11 | $33.11 | $91.20 |
United Setting Facility Modifier None Typical Low $323.59 Median $588.84 Typical High $1,621.81 | Facility | None | $323.59 | $588.84 | $1,621.81 |
United Setting Professional Modifier None Typical Low $95.50 Median $147.91 Typical High $218.78 | Professional | None | $95.50 | $147.91 | $218.78 |
11 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 $32.36 Median $53.70 Typical High $97.72 | Facility | 52 · Reduced service | $32.36 | $53.70 | $97.72 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $13.18 Median $21.38 Typical High $38.90 | Facility | 53 · Discontinued | $13.18 | $21.38 | $38.90 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $48.98 Median $79.43 Typical High $147.91 | Facility | 54 · Surgery only | $48.98 | $79.43 | $147.91 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $9.77 Median $15.85 Typical High $29.51 | Facility | 55 · Aftercare only | $9.77 | $15.85 | $29.51 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $6.61 Median $10.72 Typical High $19.50 | Facility | 56 · Pre-op care only | $6.61 | $10.72 | $19.50 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $32.36 Median $53.70 Typical High $61.66 | Professional | 52 · Reduced service | $32.36 | $53.70 | $61.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.18 Median $21.38 Typical High $25.12 | Professional | 53 · Discontinued | $13.18 | $21.38 | $25.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $48.98 Median $79.43 Typical High $93.33 | Professional | 54 · Surgery only | $48.98 | $79.43 | $93.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.77 Median $15.85 Typical High $18.62 | Professional | 55 · Aftercare only | $9.77 | $15.85 | $18.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.61 Median $10.72 Typical High $12.30 | Professional | 56 · Pre-op care only | $6.61 | $10.72 | $12.30 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $70.79 Median $70.79 Typical High $100.00 | Professional | 59 · Distinct service | $70.79 | $70.79 | $100.00 |
Where Kentucky sits
The same service costs 8.0 times more in New York than in North Dakota. 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.
Physician feeFacility fee
NY $2,762ND $346
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.