How much rates vary
Facilitymedian $81 · 10th to 90th $42 to $1,778Professionalmedian $74 · 10th to 90th $48 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 $36.31 Median $63.10 Typical High $851.14 | Facility | None | $36.31 | $63.10 | $851.14 |
Aetna Setting Professional Modifier None Typical Low $36.31 Median $63.10 Typical High $134.90 | Professional | None | $36.31 | $63.10 | $134.90 |
Anthem BCBS Setting Facility Modifier None Typical Low $77.62 Median $79.43 Typical High $9,549.93 | Facility | None | $77.62 | $79.43 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $57.54 Median $69.18 Typical High $208.93 | Professional | None | $57.54 | $69.18 | $208.93 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $87.10 Median $102.33 Typical High $309.03 | Professional | 50 · Both sides | $87.10 | $102.33 | $309.03 |
CareSource Setting Facility Modifier None Typical Low $38.90 Median $64.57 Typical High $81.28 | Facility | None | $38.90 | $64.57 | $81.28 |
CareSource Setting Professional Modifier None Typical Low $36.31 Median $52.48 Typical High $64.57 | Professional | None | $36.31 | $52.48 | $64.57 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $54.95 Typical High $398.11 | Facility | None | $34.67 | $54.95 | $398.11 |
Cigna Setting Professional Modifier None Typical Low $41.69 Median $100.00 Typical High $1,023.29 | Professional | None | $41.69 | $100.00 | $1,023.29 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $42.66 | Professional | None | $33.11 | $33.11 | $42.66 |
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 $61.66 Median $112.20 Typical High $190.55 | Professional | None | $61.66 | $112.20 | $190.55 |
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 $18.20 Median $31.62 Typical High $95.50 | Facility | 52 · Reduced service | $18.20 | $31.62 | $95.50 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $7.24 Median $12.59 Typical High $38.90 | Facility | 53 · Discontinued | $7.24 | $12.59 | $38.90 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $26.92 Median $47.86 Typical High $144.54 | Facility | 54 · Surgery only | $26.92 | $47.86 | $144.54 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $5.50 Median $9.55 Typical High $28.84 | Facility | 55 · Aftercare only | $5.50 | $9.55 | $28.84 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $3.63 Median $6.31 Typical High $19.50 | Facility | 56 · Pre-op care only | $3.63 | $6.31 | $19.50 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $18.20 Median $31.62 Typical High $37.15 | Professional | 52 · Reduced service | $18.20 | $31.62 | $37.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.24 Median $12.59 Typical High $14.79 | Professional | 53 · Discontinued | $7.24 | $12.59 | $14.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $26.92 Median $47.86 Typical High $56.23 | Professional | 54 · Surgery only | $26.92 | $47.86 | $56.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.50 Median $9.55 Typical High $11.22 | Professional | 55 · Aftercare only | $5.50 | $9.55 | $11.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.63 Median $6.31 Typical High $7.41 | Professional | 56 · Pre-op care only | $3.63 | $6.31 | $7.41 |
Where Kentucky sits
The same service costs 3.2 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
$74.13
AK $191VA $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.