How much rates vary
Facilitymedian $76 · 10th to 90th $43 to $1,148Professionalmedian $79 · 10th to 90th $44 to $151
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 $37.15 Median $64.57 Typical High $851.14 | Facility | None | $37.15 | $64.57 | $851.14 |
Aetna Setting Professional Modifier None Typical Low $37.15 Median $64.57 Typical High $97.72 | Professional | None | $37.15 | $64.57 | $97.72 |
Anthem BCBS Setting Facility Modifier None Typical Low $70.79 Median $72.44 Typical High $9,549.93 | Facility | None | $70.79 | $72.44 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $66.07 Median $79.43 Typical High $114.82 | Professional | None | $66.07 | $79.43 | $114.82 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $100.00 Median $120.23 Typical High $169.82 | Professional | 50 · Both sides | $100.00 | $120.23 | $169.82 |
CareSource Setting Facility Modifier None Typical Low $40.74 Median $66.07 Typical High $85.11 | Facility | None | $40.74 | $66.07 | $85.11 |
CareSource Setting Professional Modifier None Typical Low $41.69 Median $54.95 Typical High $66.07 | Professional | None | $41.69 | $54.95 | $66.07 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $61.66 Typical High $398.11 | Facility | None | $34.67 | $61.66 | $398.11 |
Cigna Setting Professional Modifier None Typical Low $42.66 Median $102.33 Typical High $1,000.00 | Professional | None | $42.66 | $102.33 | $1,000.00 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $39.81 | Professional | None | $33.11 | $33.11 | $39.81 |
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 $61.66 Median $117.49 Typical High $165.96 | Professional | None | $61.66 | $117.49 | $165.96 |
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 $18.62 Median $32.36 Typical High $93.33 | Facility | 52 · Reduced service | $18.62 | $32.36 | $93.33 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $7.59 Median $12.88 Typical High $38.02 | Facility | 53 · Discontinued | $7.59 | $12.88 | $38.02 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $28.18 Median $48.98 Typical High $141.25 | Facility | 54 · Surgery only | $28.18 | $48.98 | $141.25 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $5.62 Median $9.77 Typical High $28.18 | Facility | 55 · Aftercare only | $5.62 | $9.77 | $28.18 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $3.72 Median $6.46 Typical High $18.62 | Facility | 56 · Pre-op care only | $3.72 | $6.46 | $18.62 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $18.62 Median $32.36 Typical High $38.02 | Professional | 52 · Reduced service | $18.62 | $32.36 | $38.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.59 Median $12.88 Typical High $15.14 | Professional | 53 · Discontinued | $7.59 | $12.88 | $15.14 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $28.18 Median $48.98 Typical High $56.23 | Professional | 54 · Surgery only | $28.18 | $48.98 | $56.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.62 Median $9.77 Typical High $11.22 | Professional | 55 · Aftercare only | $5.62 | $9.77 | $11.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.72 Median $6.46 Typical High $7.59 | Professional | 56 · Pre-op care only | $3.72 | $6.46 | $7.59 |
Where Kentucky sits
The same service costs 3.0 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· 47th of 51
$79.43
AK $182VA $60.26
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.