How much rates vary
Facilitymedian $68 · 10th to 90th $35 to $1,778Professionalmedian $63 · 10th to 90th $47 to $117
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 $48.98 Median $52.48 Typical High $851.14 | Facility | None | $48.98 | $52.48 | $851.14 |
Aetna Setting Professional Modifier None Typical Low $48.98 Median $52.48 Typical High $91.20 | Professional | None | $48.98 | $52.48 | $91.20 |
Ambetter Setting Professional Modifier None Typical Low $48.98 Median $48.98 Typical High $48.98 | Professional | None | $48.98 | $48.98 | $48.98 |
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 $52.48 Median $63.10 Typical High $81.28 | Professional | None | $52.48 | $63.10 | $81.28 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $77.62 Median $95.50 Typical High $123.03 | Professional | 50 · Both sides | $77.62 | $95.50 | $123.03 |
CareSource Setting Facility Modifier None Typical Low $31.62 Median $42.66 Typical High $57.54 | Facility | None | $31.62 | $42.66 | $57.54 |
CareSource Setting Professional Modifier None Typical Low $41.69 Median $57.54 Typical High $70.79 | Professional | None | $41.69 | $57.54 | $70.79 |
Cigna Setting Facility Modifier None Typical Low $27.54 Median $34.67 Typical High $398.11 | Facility | None | $27.54 | $34.67 | $398.11 |
Cigna Setting Professional Modifier None Typical Low $43.65 Median $74.13 Typical High $338.84 | Professional | None | $43.65 | $74.13 | $338.84 |
Molina Setting Professional Modifier None Typical Low $26.30 Median $33.11 Typical High $33.11 | Professional | None | $26.30 | $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 $66.07 Median $85.11 Typical High $112.20 | Professional | None | $66.07 | $85.11 | $112.20 |
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 $23.99 Median $26.30 Typical High $31.62 | Facility | 52 · Reduced service | $23.99 | $26.30 | $31.62 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $9.77 Median $10.47 Typical High $12.88 | Facility | 53 · Discontinued | $9.77 | $10.47 | $12.88 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $36.31 Median $39.81 Typical High $47.86 | Facility | 54 · Surgery only | $36.31 | $39.81 | $47.86 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $7.24 Median $7.94 Typical High $9.55 | Facility | 55 · Aftercare only | $7.24 | $7.94 | $9.55 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $4.79 Median $5.25 Typical High $6.31 | Facility | 56 · Pre-op care only | $4.79 | $5.25 | $6.31 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $23.99 Median $25.70 Typical High $31.62 | Professional | 52 · Reduced service | $23.99 | $25.70 | $31.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.77 Median $10.23 Typical High $12.88 | Professional | 53 · Discontinued | $9.77 | $10.23 | $12.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $36.31 Median $38.90 Typical High $47.86 | Professional | 54 · Surgery only | $36.31 | $38.90 | $47.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.24 Median $7.76 Typical High $9.55 | Professional | 55 · Aftercare only | $7.24 | $7.76 | $9.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.79 Median $5.13 Typical High $6.31 | Professional | 56 · Pre-op care only | $4.79 | $5.13 | $6.31 |
Where Kentucky sits
The same service costs 3.6 times more in Wyoming 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
WY $191FL $52.48
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.