How much rates vary
Facilitymedian $331 · 10th to 90th $191 to $2,239Professionalmedian $251 · 10th to 90th $174 to $417
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 $213.80 Median $288.40 Typical High $851.14 | Facility | None | $213.80 | $288.40 | $851.14 |
Aetna Setting Professional Modifier None Typical Low $208.93 Median $269.15 Typical High $338.84 | Professional | None | $208.93 | $269.15 | $338.84 |
Ambetter Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $354.81 | Professional | None | $354.81 | $354.81 | $354.81 |
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 $169.82 Median $204.17 Typical High $346.74 | Professional | None | $169.82 | $204.17 | $346.74 |
CareSource Setting Facility Modifier None Typical Low $162.18 Median $204.17 Typical High $302.00 | Facility | None | $162.18 | $204.17 | $302.00 |
CareSource Setting Professional Modifier None Typical Low $190.55 Median $263.03 Typical High $309.03 | Professional | None | $190.55 | $263.03 | $309.03 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $190.55 Typical High $398.11 | Facility | None | $34.67 | $190.55 | $398.11 |
Cigna Setting Professional Modifier None Typical Low $194.98 Median $257.04 Typical High $2,041.74 | Professional | None | $194.98 | $257.04 | $2,041.74 |
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 $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 $190.55 Median $251.19 Typical High $398.11 | Professional | None | $190.55 | $251.19 | $398.11 |
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 $107.15 Median $144.54 Typical High $190.55 | Facility | 52 · Reduced service | $107.15 | $144.54 | $190.55 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $42.66 Median $57.54 Typical High $77.62 | Facility | 53 · Discontinued | $42.66 | $57.54 | $77.62 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $162.18 Median $213.80 Typical High $288.40 | Facility | 54 · Surgery only | $162.18 | $213.80 | $288.40 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $32.36 Median $42.66 Typical High $57.54 | Facility | 55 · Aftercare only | $32.36 | $42.66 | $57.54 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $21.38 Median $28.84 Typical High $38.90 | Facility | 56 · Pre-op care only | $21.38 | $28.84 | $38.90 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $107.15 Median $134.90 Typical High $151.36 | Professional | 52 · Reduced service | $107.15 | $134.90 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $42.66 Median $53.70 Typical High $60.26 | Professional | 53 · Discontinued | $42.66 | $53.70 | $60.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $162.18 Median $204.17 Typical High $223.87 | Professional | 54 · Surgery only | $162.18 | $204.17 | $223.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $32.36 Median $40.74 Typical High $44.67 | Professional | 55 · Aftercare only | $32.36 | $40.74 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.38 Median $26.92 Typical High $30.20 | Professional | 56 · Pre-op care only | $21.38 | $26.92 | $30.20 |
Where Kentucky sits
The same service costs 3.5 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· 48th of 51
$251
AK $832FL $234
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.