How much rates vary
Facilitymedian $95 · 10th to 90th $45 to $1,259Professionalmedian $65 · 10th to 90th $42 to $123
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 $41.69 Median $70.79 Typical High $138.04 | Facility | None | $41.69 | $70.79 | $138.04 |
Aetna Setting Professional Modifier None Typical Low $41.69 Median $67.61 Typical High $131.83 | Professional | None | $41.69 | $67.61 | $131.83 |
Ambetter Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $89.13 | Professional | None | $89.13 | $89.13 | $89.13 |
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 $38.90 Median $56.23 Typical High $81.28 | Professional | None | $38.90 | $56.23 | $81.28 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $58.88 Median $85.11 Typical High $123.03 | Professional | 50 · Both sides | $58.88 | $85.11 | $123.03 |
CareSource Setting Facility Modifier None Typical Low $42.66 Median $707.95 Typical High $1,258.93 | Facility | None | $42.66 | $707.95 | $1,258.93 |
CareSource Setting Professional Modifier None Typical Low $54.95 Median $72.44 Typical High $102.33 | Professional | None | $54.95 | $72.44 | $102.33 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $74.13 Typical High $75.86 | Facility | None | $34.67 | $74.13 | $75.86 |
Cigna Setting Professional Modifier None Typical Low $44.67 Median $85.11 Typical High $512.86 | Professional | None | $44.67 | $85.11 | $512.86 |
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 $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 $46.77 Median $81.28 Typical High $147.91 | Professional | None | $46.77 | $81.28 | $147.91 |
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 $20.89 Median $33.88 Typical High $47.86 | Facility | 52 · Reduced service | $20.89 | $33.88 | $47.86 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $8.32 Median $13.80 Typical High $19.05 | Facility | 53 · Discontinued | $8.32 | $13.80 | $19.05 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $31.62 Median $51.29 Typical High $72.44 | Facility | 54 · Surgery only | $31.62 | $51.29 | $72.44 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $6.31 Median $10.23 Typical High $14.45 | Facility | 55 · Aftercare only | $6.31 | $10.23 | $14.45 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $4.17 Median $6.76 Typical High $9.55 | Facility | 56 · Pre-op care only | $4.17 | $6.76 | $9.55 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $20.89 Median $33.11 Typical High $37.15 | Professional | 52 · Reduced service | $20.89 | $33.11 | $37.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.32 Median $13.49 Typical High $14.79 | Professional | 53 · Discontinued | $8.32 | $13.49 | $14.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $31.62 Median $50.12 Typical High $56.23 | Professional | 54 · Surgery only | $31.62 | $50.12 | $56.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.31 Median $10.00 Typical High $11.22 | Professional | 55 · Aftercare only | $6.31 | $10.00 | $11.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.17 Median $6.61 Typical High $7.41 | Professional | 56 · Pre-op care only | $4.17 | $6.61 | $7.41 |
Where Kentucky sits
The same service costs 3.3 times more in Alaska than in Kentucky. 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· 51st of 51
$64.57
AK $214KY $64.57
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.