How much rates vary
Facilitymedian $2,291 · 10th to 90th $724 to $5,370Professionalmedian $275 · 10th to 90th $170 to $479
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 $218.78 Median $1,348.96 Typical High $5,623.41 | Facility | None | $218.78 | $1,348.96 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $158.49 Median $239.88 Typical High $416.87 | Professional | None | $158.49 | $239.88 | $416.87 |
BCBS Setting Facility Modifier None Typical Low $1,778.28 Median $2,454.71 Typical High $4,168.69 | Facility | None | $1,778.28 | $2,454.71 | $4,168.69 |
BCBS Setting Professional Modifier None Typical Low $223.87 Median $316.23 Typical High $501.19 | Professional | None | $223.87 | $316.23 | $501.19 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $2,187.76 Typical High $2,818.38 | Facility | None | $630.96 | $2,187.76 | $2,818.38 |
Cigna Setting Professional Modifier None Typical Low $173.78 Median $275.42 Typical High $467.74 | Professional | None | $173.78 | $275.42 | $467.74 |
Hally Health Setting Professional Modifier None Typical Low $199.53 Median $346.74 Typical High $630.96 | Professional | None | $199.53 | $346.74 | $630.96 |
Hally Health Setting Facility Modifier None Typical Low $100.00 Median $100.00 Typical High $100.00 | Facility | None | $100.00 | $100.00 | $100.00 |
Hally Health Setting Professional Modifier None Typical Low $208.93 Median $229.09 Typical High $363.08 | Professional | None | $208.93 | $229.09 | $363.08 |
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 $1,047.13 Median $2,454.71 Typical High $6,918.31 | Facility | None | $1,047.13 | $2,454.71 | $6,918.31 |
United Setting Professional Modifier None Typical Low $173.78 Median $269.15 Typical High $467.74 | Professional | None | $173.78 | $269.15 | $467.74 |
7 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 Professional Modifier 52 · Reduced service Typical Low $75.86 Median $109.65 Typical High $123.03 | Professional | 52 · Reduced service | $75.86 | $109.65 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $43.65 Typical High $48.98 | Professional | 53 · Discontinued | $30.20 | $43.65 | $48.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $162.18 Typical High $186.21 | Professional | 54 · Surgery only | $114.82 | $162.18 | $186.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $32.36 Typical High $37.15 | Professional | 55 · Aftercare only | $22.91 | $32.36 | $37.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $21.88 Typical High $24.55 | Professional | 56 · Pre-op care only | $15.14 | $21.88 | $24.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $107.15 Median $151.36 Typical High $173.78 | Professional | 78 · Unplanned return to OR | $107.15 | $151.36 | $173.78 |
Ambetter Setting Professional Modifier 51 · Multiple procedures Typical Low $223.87 Median $223.87 Typical High $223.87 | Professional | 51 · Multiple procedures | $223.87 | $223.87 | $223.87 |
Where Illinois sits
The same service costs 9.3 times more in Colorado than in Montana. 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.
Physician feeFacility fee
CO $5,912MT $637
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.