How much rates vary
Facilitymedian $832 · 10th to 90th $112 to $2,818Professionalmedian $110 · 10th to 90th $76 to $204
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 $72.44 Median $120.23 Typical High $794.33 | Facility | None | $72.44 | $120.23 | $794.33 |
Aetna Setting Professional Modifier None Typical Low $72.44 Median $112.20 Typical High $165.96 | Professional | None | $72.44 | $112.20 | $165.96 |
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 $74.13 Median $89.13 Typical High $107.15 | Professional | None | $74.13 | $89.13 | $107.15 |
CareSource Setting Facility Modifier None Typical Low $77.62 Median $128.82 Typical High $812.83 | Facility | None | $77.62 | $128.82 | $812.83 |
CareSource Setting Professional Modifier None Typical Low $79.43 Median $107.15 Typical High $131.83 | Professional | None | $79.43 | $107.15 | $131.83 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $512.86 Typical High $691.83 | Facility | None | $34.67 | $512.86 | $691.83 |
Cigna Setting Professional Modifier None Typical Low $81.28 Median $128.82 Typical High $741.31 | Professional | None | $81.28 | $128.82 | $741.31 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $89.13 | Professional | None | $33.11 | $33.11 | $89.13 |
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 $97.72 Median $151.36 Typical High $218.78 | Professional | None | $97.72 | $151.36 | $218.78 |
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 $35.48 Median $54.95 Typical High $97.72 | Facility | 52 · Reduced service | $35.48 | $54.95 | $97.72 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $14.45 Median $22.39 Typical High $38.90 | Facility | 53 · Discontinued | $14.45 | $22.39 | $38.90 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $53.70 Median $83.18 Typical High $147.91 | Facility | 54 · Surgery only | $53.70 | $83.18 | $147.91 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $10.72 Median $16.60 Typical High $29.51 | Facility | 55 · Aftercare only | $10.72 | $16.60 | $29.51 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $7.24 Median $11.22 Typical High $19.50 | Facility | 56 · Pre-op care only | $7.24 | $11.22 | $19.50 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $35.48 Median $54.95 Typical High $64.57 | Professional | 52 · Reduced service | $35.48 | $54.95 | $64.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.45 Median $22.39 Typical High $25.70 | Professional | 53 · Discontinued | $14.45 | $22.39 | $25.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $53.70 Median $83.18 Typical High $97.72 | Professional | 54 · Surgery only | $53.70 | $83.18 | $97.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.72 Median $16.60 Typical High $19.50 | Professional | 55 · Aftercare only | $10.72 | $16.60 | $19.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.24 Median $11.22 Typical High $12.88 | Professional | 56 · Pre-op care only | $7.24 | $11.22 | $12.88 |
Where Kentucky sits
The same service costs 7.8 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 $2,820ND $362
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.