How much rates vary
Facilitymedian $78 · 10th to 90th $35 to $1,380Professionalmedian $37 · 10th to 90th $30 to $62
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 $35.48 Median $42.66 Typical High $69.18 | Facility | None | $35.48 | $42.66 | $69.18 |
Aetna Setting Professional Modifier None Typical Low $33.88 Median $40.74 Typical High $53.70 | Professional | None | $33.88 | $40.74 | $53.70 |
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 $26.30 Median $32.36 Typical High $39.81 | Professional | None | $26.30 | $32.36 | $39.81 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $39.81 Median $47.86 Typical High $60.26 | Professional | 50 · Both sides | $39.81 | $47.86 | $60.26 |
CareSource Setting Facility Modifier None Typical Low $30.90 Median $524.81 Typical High $933.25 | Facility | None | $30.90 | $524.81 | $933.25 |
CareSource Setting Professional Modifier None Typical Low $30.90 Median $43.65 Typical High $51.29 | Professional | None | $30.90 | $43.65 | $51.29 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $51.29 Typical High $75.86 | Facility | None | $34.67 | $51.29 | $75.86 |
Cigna Setting Professional Modifier None Typical Low $31.62 Median $39.81 Typical High $288.40 | Professional | None | $31.62 | $39.81 | $288.40 |
Molina Setting Professional Modifier None Typical Low $21.88 Median $33.11 Typical High $33.11 | Professional | None | $21.88 | $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 $30.90 Median $37.15 Typical High $61.66 | Professional | None | $30.90 | $37.15 | $61.66 |
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 $17.78 Median $21.38 Typical High $26.92 | Facility | 52 · Reduced service | $17.78 | $21.38 | $26.92 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $7.08 Median $8.51 Typical High $10.72 | Facility | 53 · Discontinued | $7.08 | $8.51 | $10.72 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $26.30 Median $31.62 Typical High $40.74 | Facility | 54 · Surgery only | $26.30 | $31.62 | $40.74 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $5.25 Median $6.31 Typical High $8.13 | Facility | 55 · Aftercare only | $5.25 | $6.31 | $8.13 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $3.55 Median $4.27 Typical High $5.37 | Facility | 56 · Pre-op care only | $3.55 | $4.27 | $5.37 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $17.78 Median $20.42 Typical High $21.88 | Professional | 52 · Reduced service | $17.78 | $20.42 | $21.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.08 Median $8.32 Typical High $8.91 | Professional | 53 · Discontinued | $7.08 | $8.32 | $8.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $26.30 Median $30.90 Typical High $33.11 | Professional | 54 · Surgery only | $26.30 | $30.90 | $33.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.25 Median $6.17 Typical High $6.61 | Professional | 55 · Aftercare only | $5.25 | $6.17 | $6.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.55 Median $4.07 Typical High $4.47 | Professional | 56 · Pre-op care only | $3.55 | $4.07 | $4.47 |
Where Kentucky sits
The same service costs 3.8 times more in Alaska than in Utah. 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
$38.02
AK $135UT $35.48
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.