How much rates vary
Facilitymedian $59 · 10th to 90th $20 to $1,905Professionalmedian $39 · 10th to 90th $20 to $155
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 $20.42 Median $26.30 Typical High $851.14 | Facility | None | $20.42 | $26.30 | $851.14 |
Aetna Setting Professional Modifier None Typical Low $20.42 Median $26.30 Typical High $36.31 | Professional | None | $20.42 | $26.30 | $36.31 |
Ambetter Setting Professional Modifier None Typical Low $29.51 Median $29.51 Typical High $29.51 | Professional | None | $29.51 | $29.51 | $29.51 |
Anthem BCBS Setting Facility Modifier None Typical Low $575.44 Median $3,801.89 Typical High $11,220.18 | Facility | None | $575.44 | $3,801.89 | $11,220.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $18.62 Median $107.15 Typical High $154.88 | Professional | None | $18.62 | $107.15 | $154.88 |
CareSource Setting Facility Modifier None Typical Low $19.05 Median $23.44 Typical High $45.71 | Facility | None | $19.05 | $23.44 | $45.71 |
CareSource Setting Professional Modifier None Typical Low $22.91 Median $29.51 Typical High $36.31 | Professional | None | $22.91 | $29.51 | $36.31 |
Cigna Setting Facility Modifier None Typical Low $17.38 Median $34.67 Typical High $524.81 | Facility | None | $17.38 | $34.67 | $524.81 |
Cigna Setting Professional Modifier None Typical Low $23.44 Median $34.67 Typical High $245.47 | Professional | None | $23.44 | $34.67 | $245.47 |
Molina Setting Professional Modifier None Typical Low $19.50 Median $33.11 Typical High $33.11 | Professional | None | $19.50 | $33.11 | $33.11 |
United Setting Facility Modifier None Typical Low $70.79 Median $186.21 Typical High $1,148.15 | Facility | None | $70.79 | $186.21 | $1,148.15 |
United Setting Professional Modifier None Typical Low $24.55 Median $36.31 Typical High $54.95 | Professional | None | $24.55 | $36.31 | $54.95 |
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 $10.23 Median $12.02 Typical High $15.49 | Facility | 52 · Reduced service | $10.23 | $12.02 | $15.49 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $4.07 Median $4.79 Typical High $6.17 | Facility | 53 · Discontinued | $4.07 | $4.79 | $6.17 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $15.14 Median $17.78 Typical High $22.91 | Facility | 54 · Surgery only | $15.14 | $17.78 | $22.91 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $3.09 Median $3.55 Typical High $4.57 | Facility | 55 · Aftercare only | $3.09 | $3.55 | $4.57 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $2.04 Median $2.40 Typical High $3.09 | Facility | 56 · Pre-op care only | $2.04 | $2.40 | $3.09 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $10.23 Median $13.18 Typical High $15.49 | Professional | 52 · Reduced service | $10.23 | $13.18 | $15.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.07 Median $5.25 Typical High $6.17 | Professional | 53 · Discontinued | $4.07 | $5.25 | $6.17 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $15.14 Median $19.50 Typical High $22.91 | Professional | 54 · Surgery only | $15.14 | $19.50 | $22.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.09 Median $3.98 Typical High $4.57 | Professional | 55 · Aftercare only | $3.09 | $3.98 | $4.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.04 Median $2.63 Typical High $3.09 | Professional | 56 · Pre-op care only | $2.04 | $2.63 | $3.09 |
Where Kentucky sits
The same service costs 3.5 times more in Alaska than in Maryland. 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· 26th of 51
$39.81
AK $100MD $28.84
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.