How much rates vary
Facilitymedian $76 · 10th to 90th $51 to $1,479Professionalmedian $63 · 10th to 90th $46 to $98
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 $51.29 Median $69.18 Typical High $93.33 | Facility | None | $51.29 | $69.18 | $93.33 |
Aetna Setting Professional Modifier None Typical Low $50.12 Median $67.61 Typical High $85.11 | Professional | None | $50.12 | $67.61 | $85.11 |
Ambetter Setting Professional Modifier None Typical Low $57.54 Median $63.10 Typical High $87.10 | Professional | None | $57.54 | $63.10 | $87.10 |
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 $42.66 Median $53.70 Typical High $66.07 | Professional | None | $42.66 | $53.70 | $66.07 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $64.57 Median $79.43 Typical High $100.00 | Professional | 50 · Both sides | $64.57 | $79.43 | $100.00 |
CareSource Setting Facility Modifier None Typical Low $38.90 Median $46.77 Typical High $72.44 | Facility | None | $38.90 | $46.77 | $72.44 |
CareSource Setting Professional Modifier None Typical Low $56.23 Median $66.07 Typical High $83.18 | Professional | None | $56.23 | $66.07 | $83.18 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $74.13 Typical High $75.86 | Facility | None | $34.67 | $74.13 | $75.86 |
Cigna Setting Professional Modifier None Typical Low $46.77 Median $64.57 Typical High $398.11 | Professional | None | $46.77 | $64.57 | $398.11 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $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 $51.29 Median $66.07 Typical High $97.72 | Professional | None | $51.29 | $66.07 | $97.72 |
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 $25.70 Median $34.67 Typical High $38.02 | Facility | 52 · Reduced service | $25.70 | $34.67 | $38.02 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $10.23 Median $13.80 Typical High $15.49 | Facility | 53 · Discontinued | $10.23 | $13.80 | $15.49 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $38.90 Median $52.48 Typical High $57.54 | Facility | 54 · Surgery only | $38.90 | $52.48 | $57.54 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $7.76 Median $10.47 Typical High $11.48 | Facility | 55 · Aftercare only | $7.76 | $10.47 | $11.48 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $5.13 Median $6.92 Typical High $7.59 | Facility | 56 · Pre-op care only | $5.13 | $6.92 | $7.59 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $25.70 Median $33.11 Typical High $36.31 | Professional | 52 · Reduced service | $25.70 | $33.11 | $36.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.23 Median $13.49 Typical High $14.45 | Professional | 53 · Discontinued | $10.23 | $13.49 | $14.45 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $38.90 Median $50.12 Typical High $53.70 | Professional | 54 · Surgery only | $38.90 | $50.12 | $53.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.76 Median $10.00 Typical High $10.72 | Professional | 55 · Aftercare only | $7.76 | $10.00 | $10.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.13 Median $6.61 Typical High $7.24 | Professional | 56 · Pre-op care only | $5.13 | $6.61 | $7.24 |
Where Kentucky sits
The same service costs 3.6 times more in Alaska than in Florida. 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· 45th of 51
$63.10
AK $200FL $54.95
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.