How much rates vary
Facilitymedian $72 · 10th to 90th $40 to $1,445Professionalmedian $63 · 10th to 90th $37 to $123
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 $34.67 Median $69.18 Typical High $416.87 | Facility | None | $34.67 | $69.18 | $416.87 |
Aetna Setting Professional Modifier None Typical Low $36.31 Median $61.66 Typical High $112.20 | Professional | None | $36.31 | $61.66 | $112.20 |
Ambetter Setting Professional Modifier None Typical Low $23.44 Median $37.15 Typical High $37.15 | Professional | None | $23.44 | $37.15 | $37.15 |
Anthem BCBS Setting Facility Modifier None Typical Low $64.57 Median $66.07 Typical High $9,549.93 | Facility | None | $64.57 | $66.07 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $37.15 Median $52.48 Typical High $89.13 | Professional | None | $37.15 | $52.48 | $89.13 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $56.23 Median $79.43 Typical High $131.83 | Professional | 50 · Both sides | $56.23 | $79.43 | $131.83 |
CareSource Setting Facility Modifier None Typical Low $38.02 Median $53.70 Typical High $75.86 | Facility | None | $38.02 | $53.70 | $75.86 |
CareSource Setting Professional Modifier None Typical Low $53.70 Median $67.61 Typical High $93.33 | Professional | None | $53.70 | $67.61 | $93.33 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $63.10 Typical High $398.11 | Facility | None | $34.67 | $63.10 | $398.11 |
Cigna Setting Professional Modifier None Typical Low $39.81 Median $81.28 Typical High $707.95 | Professional | None | $39.81 | $81.28 | $707.95 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $45.71 | Professional | None | $33.11 | $33.11 | $45.71 |
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 $60.26 Median $95.50 Typical High $141.25 | Professional | None | $60.26 | $95.50 | $141.25 |
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 $17.38 Median $29.51 Typical High $67.61 | Facility | 52 · Reduced service | $17.38 | $29.51 | $67.61 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $6.92 Median $12.02 Typical High $26.92 | Facility | 53 · Discontinued | $6.92 | $12.02 | $26.92 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $25.70 Median $44.67 Typical High $100.00 | Facility | 54 · Surgery only | $25.70 | $44.67 | $100.00 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $5.13 Median $8.91 Typical High $19.95 | Facility | 55 · Aftercare only | $5.13 | $8.91 | $19.95 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $3.47 Median $5.89 Typical High $13.49 | Facility | 56 · Pre-op care only | $3.47 | $5.89 | $13.49 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $17.38 Median $29.51 Typical High $34.67 | Professional | 52 · Reduced service | $17.38 | $29.51 | $34.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.92 Median $12.02 Typical High $13.80 | Professional | 53 · Discontinued | $6.92 | $12.02 | $13.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $25.70 Median $44.67 Typical High $52.48 | Professional | 54 · Surgery only | $25.70 | $44.67 | $52.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.13 Median $8.91 Typical High $10.47 | Professional | 55 · Aftercare only | $5.13 | $8.91 | $10.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.47 Median $5.89 Typical High $6.92 | Professional | 56 · Pre-op care only | $3.47 | $5.89 | $6.92 |
Where Kentucky sits
The same service costs 3.5 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· 50th of 51
$64.57
AK $204VA $58.88
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.