How much rates vary
Facilitymedian $115 · 10th to 90th $20 to $1,380Professionalmedian $42 · 10th to 90th $19 to $78
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 $19.50 Median $22.91 Typical High $125.89 | Facility | None | $19.50 | $22.91 | $125.89 |
Aetna Setting Professional Modifier None Typical Low $19.50 Median $22.91 Typical High $53.70 | Professional | None | $19.50 | $22.91 | $53.70 |
Ambetter Setting Professional Modifier None Typical Low $16.60 Median $17.78 Typical High $17.78 | Professional | None | $16.60 | $17.78 | $17.78 |
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 $24.55 Median $46.77 Typical High $54.95 | Professional | None | $24.55 | $46.77 | $54.95 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $37.15 Median $69.18 Typical High $81.28 | Professional | 50 · Both sides | $37.15 | $69.18 | $81.28 |
CareSource Setting Facility Modifier None Typical Low $19.95 Median $524.81 Typical High $933.25 | Facility | None | $19.95 | $524.81 | $933.25 |
CareSource Setting Professional Modifier None Typical Low $18.62 Median $23.99 Typical High $33.11 | Professional | None | $18.62 | $23.99 | $33.11 |
Cigna Setting Facility Modifier None Typical Low $32.36 Median $34.67 Typical High $75.86 | Facility | None | $32.36 | $34.67 | $75.86 |
Cigna Setting Professional Modifier None Typical Low $17.78 Median $40.74 Typical High $660.69 | Professional | None | $17.78 | $40.74 | $660.69 |
Molina Setting Professional Modifier None Typical Low $31.62 Median $33.11 Typical High $33.11 | Professional | None | $31.62 | $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 $32.36 Median $48.98 Typical High $63.10 | Professional | None | $32.36 | $48.98 | $63.10 |
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 $9.77 Median $11.48 Typical High $61.66 | Facility | 52 · Reduced service | $9.77 | $11.48 | $61.66 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $3.89 Median $4.57 Typical High $25.12 | Facility | 53 · Discontinued | $3.89 | $4.57 | $25.12 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $14.79 Median $16.98 Typical High $93.33 | Facility | 54 · Surgery only | $14.79 | $16.98 | $93.33 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $2.95 Median $3.39 Typical High $18.62 | Facility | 55 · Aftercare only | $2.95 | $3.39 | $18.62 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $1.95 Median $2.29 Typical High $12.59 | Facility | 56 · Pre-op care only | $1.95 | $2.29 | $12.59 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $9.77 Median $10.96 Typical High $14.13 | Professional | 52 · Reduced service | $9.77 | $10.96 | $14.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.89 Median $4.47 Typical High $5.62 | Professional | 53 · Discontinued | $3.89 | $4.47 | $5.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $14.79 Median $16.60 Typical High $20.89 | Professional | 54 · Surgery only | $14.79 | $16.60 | $20.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.95 Median $3.31 Typical High $4.17 | Professional | 55 · Aftercare only | $2.95 | $3.31 | $4.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.95 Median $2.19 Typical High $2.82 | Professional | 56 · Pre-op care only | $1.95 | $2.19 | $2.82 |
Where Kentucky sits
The same service costs 4.3 times more in Wyoming than in New York. 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· 26th of 51
$43.65
WY $89.13NY $20.89
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.