How much rates vary
Facilitymedian $102 · 10th to 90th $54 to $1,622Professionalmedian $69 · 10th to 90th $51 to $158
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 $46.77 Median $69.18 Typical High $851.14 | Facility | None | $46.77 | $69.18 | $851.14 |
Aetna Setting Professional Modifier None Typical Low $46.77 Median $69.18 Typical High $147.91 | Professional | None | $46.77 | $69.18 | $147.91 |
Ambetter Setting Professional Modifier None Typical Low $46.77 Median $46.77 Typical High $58.88 | Professional | None | $46.77 | $46.77 | $58.88 |
Anthem BCBS Setting Facility Modifier None Typical Low $100.00 Median $102.33 Typical High $9,549.93 | Facility | None | $100.00 | $102.33 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $51.29 Median $60.26 Typical High $91.20 | Professional | None | $51.29 | $60.26 | $91.20 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $77.62 Median $93.33 Typical High $138.04 | Professional | 50 · Both sides | $77.62 | $93.33 | $138.04 |
CareSource Setting Facility Modifier None Typical Low $50.12 Median $58.88 Typical High $83.18 | Facility | None | $50.12 | $58.88 | $83.18 |
CareSource Setting Professional Modifier None Typical Low $51.29 Median $67.61 Typical High $83.18 | Professional | None | $51.29 | $67.61 | $83.18 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $60.26 Typical High $398.11 | Facility | None | $34.67 | $60.26 | $398.11 |
Cigna Setting Professional Modifier None Typical Low $52.48 Median $93.33 Typical High $870.96 | Professional | None | $52.48 | $93.33 | $870.96 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $50.12 | Professional | None | $33.11 | $33.11 | $50.12 |
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 $69.18 Median $102.33 Typical High $186.21 | Professional | None | $69.18 | $102.33 | $186.21 |
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 $23.44 Median $34.67 Typical High $83.18 | Facility | 52 · Reduced service | $23.44 | $34.67 | $83.18 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $9.33 Median $14.13 Typical High $33.11 | Facility | 53 · Discontinued | $9.33 | $14.13 | $33.11 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $34.67 Median $52.48 Typical High $123.03 | Facility | 54 · Surgery only | $34.67 | $52.48 | $123.03 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $6.92 Median $10.47 Typical High $24.55 | Facility | 55 · Aftercare only | $6.92 | $10.47 | $24.55 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $4.68 Median $7.08 Typical High $16.60 | Facility | 56 · Pre-op care only | $4.68 | $7.08 | $16.60 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $23.44 Median $34.67 Typical High $40.74 | Professional | 52 · Reduced service | $23.44 | $34.67 | $40.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.33 Median $14.13 Typical High $16.22 | Professional | 53 · Discontinued | $9.33 | $14.13 | $16.22 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $34.67 Median $52.48 Typical High $61.66 | Professional | 54 · Surgery only | $34.67 | $52.48 | $61.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.92 Median $10.47 Typical High $12.30 | Professional | 55 · Aftercare only | $6.92 | $10.47 | $12.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.68 Median $7.08 Typical High $8.13 | Professional | 56 · Pre-op care only | $4.68 | $7.08 | $8.13 |
Where Kentucky sits
The same service costs 3.2 times more in Alaska than in Kentucky. 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· 51st of 51
$69.18
AK $224KY $69.18
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.