How much rates vary
Facilitymedian $741 · 10th to 90th $85 to $2,818Professionalmedian $117 · 10th to 90th $89 to $251
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 $95.50 Median $114.82 Typical High $851.14 | Facility | None | $95.50 | $114.82 | $851.14 |
Aetna Setting Professional Modifier None Typical Low $91.20 Median $114.82 Typical High $186.21 | Professional | None | $91.20 | $114.82 | $186.21 |
Ambetter Setting Professional Modifier None Typical Low $107.15 Median $109.65 Typical High $134.90 | Professional | None | $107.15 | $109.65 | $134.90 |
Anthem BCBS Setting Facility Modifier None Typical Low $588.84 Median $1,698.24 Typical High $2,884.03 | Facility | None | $588.84 | $1,698.24 | $2,884.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $87.10 Median $125.89 Typical High $177.83 | Professional | None | $87.10 | $125.89 | $177.83 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $131.83 Median $190.55 Typical High $257.04 | Professional | 50 · Both sides | $131.83 | $190.55 | $257.04 |
CareSource Setting Facility Modifier None Typical Low $77.62 Median $95.50 Typical High $134.90 | Facility | None | $77.62 | $95.50 | $134.90 |
CareSource Setting Professional Modifier None Typical Low $102.33 Median $112.20 Typical High $141.25 | Professional | None | $102.33 | $112.20 | $141.25 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $75.86 Typical High $398.11 | Facility | None | $34.67 | $75.86 | $398.11 |
Cigna Setting Professional Modifier None Typical Low $85.11 Median $138.04 Typical High $3,235.94 | Professional | None | $85.11 | $138.04 | $3,235.94 |
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 $97.72 Median $134.90 Typical High $223.87 | Professional | None | $97.72 | $134.90 | $223.87 |
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 $47.86 Median $57.54 Typical High $302.00 | Facility | 52 · Reduced service | $47.86 | $57.54 | $302.00 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $19.05 Median $22.91 Typical High $120.23 | Facility | 53 · Discontinued | $19.05 | $22.91 | $120.23 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $70.79 Median $87.10 Typical High $457.09 | Facility | 54 · Surgery only | $70.79 | $87.10 | $457.09 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $14.45 Median $17.38 Typical High $91.20 | Facility | 55 · Aftercare only | $14.45 | $17.38 | $91.20 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $9.55 Median $11.48 Typical High $60.26 | Facility | 56 · Pre-op care only | $9.55 | $11.48 | $60.26 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $47.86 Median $56.23 Typical High $60.26 | Professional | 52 · Reduced service | $47.86 | $56.23 | $60.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.05 Median $22.39 Typical High $23.99 | Professional | 53 · Discontinued | $19.05 | $22.39 | $23.99 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $70.79 Median $85.11 Typical High $91.20 | Professional | 54 · Surgery only | $70.79 | $85.11 | $91.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.45 Median $16.98 Typical High $18.20 | Professional | 55 · Aftercare only | $14.45 | $16.98 | $18.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.55 Median $11.22 Typical High $12.02 | Professional | 56 · Pre-op care only | $9.55 | $11.22 | $12.02 |
Where Kentucky sits
The same service costs 3.7 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· 42nd of 51
$120
AK $363FL $97.72
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.