How much rates vary
Facilitymedian $62 · 10th to 90th $50 to $3,311Professionalmedian $58 · 10th to 90th $44 to $100
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 $53.70 Median $60.26 Typical High $851.14 | Facility | None | $53.70 | $60.26 | $851.14 |
Aetna Setting Professional Modifier None Typical Low $51.29 Median $58.88 Typical High $79.43 | Professional | None | $51.29 | $58.88 | $79.43 |
Anthem BCBS Setting Facility Modifier None Typical Low $9,120.11 Median $10,715.19 Typical High $11,220.18 | Facility | None | $9,120.11 | $10,715.19 | $11,220.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $41.69 Median $51.29 Typical High $75.86 | Professional | None | $41.69 | $51.29 | $75.86 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $63.10 Median $75.86 Typical High $114.82 | Professional | 50 · Both sides | $63.10 | $75.86 | $114.82 |
CareSource Setting Facility Modifier None Typical Low $39.81 Median $47.86 Typical High $75.86 | Facility | None | $39.81 | $47.86 | $75.86 |
CareSource Setting Professional Modifier None Typical Low $46.77 Median $66.07 Typical High $77.62 | Professional | None | $46.77 | $66.07 | $77.62 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $79.43 Typical High $79.43 | Facility | None | $34.67 | $79.43 | $79.43 |
Cigna Setting Professional Modifier None Typical Low $47.86 Median $74.13 Typical High $3,548.13 | Professional | None | $47.86 | $74.13 | $3,548.13 |
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 $50.12 Median $416.87 Typical High $1,949.84 | Facility | None | $50.12 | $416.87 | $1,949.84 |
United Setting Professional Modifier None Typical Low $52.48 Median $63.10 Typical High $107.15 | Professional | None | $52.48 | $63.10 | $107.15 |
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 $26.92 Median $29.51 Typical High $331.13 | Facility | 52 · Reduced service | $26.92 | $29.51 | $331.13 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $10.72 Median $12.02 Typical High $131.83 | Facility | 53 · Discontinued | $10.72 | $12.02 | $131.83 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $39.81 Median $44.67 Typical High $501.19 | Facility | 54 · Surgery only | $39.81 | $44.67 | $501.19 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $7.94 Median $8.91 Typical High $100.00 | Facility | 55 · Aftercare only | $7.94 | $8.91 | $100.00 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $5.37 Median $6.03 Typical High $66.07 | Facility | 56 · Pre-op care only | $5.37 | $6.03 | $66.07 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $25.70 Median $28.84 Typical High $38.90 | Professional | 52 · Reduced service | $25.70 | $28.84 | $38.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.23 Median $11.75 Typical High $15.49 | Professional | 53 · Discontinued | $10.23 | $11.75 | $15.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $38.90 Median $43.65 Typical High $58.88 | Professional | 54 · Surgery only | $38.90 | $43.65 | $58.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.76 Median $8.71 Typical High $11.75 | Professional | 55 · Aftercare only | $7.76 | $8.71 | $11.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.13 Median $5.75 Typical High $7.76 | Professional | 56 · Pre-op care only | $5.13 | $5.75 | $7.76 |
Where Kentucky sits
The same service costs 3.4 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· 50th of 51
$57.54
AK $182FL $53.70
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.