How much rates vary
Facilitymedian $100 · 10th to 90th $46 to $1,479Professionalmedian $72 · 10th to 90th $46 to $138
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 $45.71 Median $67.61 Typical High $102.33 | Facility | None | $45.71 | $67.61 | $102.33 |
Aetna Setting Professional Modifier None Typical Low $45.71 Median $67.61 Typical High $125.89 | Professional | None | $45.71 | $67.61 | $125.89 |
Ambetter Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $72.44 | Professional | None | $72.44 | $72.44 | $72.44 |
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 $44.67 Median $72.44 Typical High $114.82 | Professional | None | $44.67 | $72.44 | $114.82 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $66.07 Median $109.65 Typical High $169.82 | Professional | 50 · Both sides | $66.07 | $109.65 | $169.82 |
CareSource Setting Facility Modifier None Typical Low $40.74 Median $48.98 Typical High $75.86 | Facility | None | $40.74 | $48.98 | $75.86 |
CareSource Setting Professional Modifier None Typical Low $52.48 Median $66.07 Typical High $79.43 | Professional | None | $52.48 | $66.07 | $79.43 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $75.86 Typical High $77.62 | Facility | None | $34.67 | $75.86 | $77.62 |
Cigna Setting Professional Modifier None Typical Low $48.98 Median $87.10 Typical High $549.54 | Professional | None | $48.98 | $87.10 | $549.54 |
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 $52.48 Median $89.13 Typical High $154.88 | Professional | None | $52.48 | $89.13 | $154.88 |
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 $22.91 Median $33.88 Typical High $51.29 | Facility | 52 · Reduced service | $22.91 | $33.88 | $51.29 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $9.12 Median $13.49 Typical High $20.42 | Facility | 53 · Discontinued | $9.12 | $13.49 | $20.42 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $33.88 Median $50.12 Typical High $77.62 | Facility | 54 · Surgery only | $33.88 | $50.12 | $77.62 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $6.76 Median $10.00 Typical High $15.49 | Facility | 55 · Aftercare only | $6.76 | $10.00 | $15.49 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $4.57 Median $6.76 Typical High $10.23 | Facility | 56 · Pre-op care only | $4.57 | $6.76 | $10.23 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $22.91 Median $33.11 Typical High $36.31 | Professional | 52 · Reduced service | $22.91 | $33.11 | $36.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.12 Median $13.18 Typical High $14.45 | Professional | 53 · Discontinued | $9.12 | $13.18 | $14.45 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $33.88 Median $48.98 Typical High $54.95 | Professional | 54 · Surgery only | $33.88 | $48.98 | $54.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.76 Median $10.00 Typical High $10.96 | Professional | 55 · Aftercare only | $6.76 | $10.00 | $10.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.57 Median $6.61 Typical High $7.24 | Professional | 56 · Pre-op care only | $4.57 | $6.61 | $7.24 |
Where Kentucky sits
The same service costs 3.2 times more in Wisconsin 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
$72.44
WI $229KY $72.44
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.