How much rates vary
Facilitymedian $603 · 10th to 90th $91 to $3,388Professionalmedian $126 · 10th to 90th $65 to $229
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 $50.12 Median $109.65 Typical High $7,413.10 | Facility | None | $50.12 | $109.65 | $7,413.10 |
Aetna Setting Professional Modifier None Typical Low $50.12 Median $109.65 Typical High $257.04 | Professional | None | $50.12 | $109.65 | $257.04 |
Ambetter Setting Professional Modifier None Typical Low $61.66 Median $194.98 Typical High $275.42 | Professional | None | $61.66 | $194.98 | $275.42 |
Anthem BCBS Setting Facility Modifier None Typical Low $478.63 Median $851.14 Typical High $3,630.78 | Facility | None | $478.63 | $851.14 | $3,630.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $72.44 Median $128.82 Typical High $194.98 | Professional | None | $72.44 | $128.82 | $194.98 |
CareSource Setting Professional Modifier None Typical Low $104.71 Median $112.20 Typical High $123.03 | Professional | None | $104.71 | $112.20 | $123.03 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $346.74 Typical High $4,265.80 | Facility | None | $50.12 | $346.74 | $4,265.80 |
Cigna Setting Professional Modifier None Typical Low $50.12 Median $114.82 Typical High $275.42 | Professional | None | $50.12 | $114.82 | $275.42 |
Kaiser Permanente Setting Professional Modifier None Typical Low $64.57 Median $158.49 Typical High $269.15 | Professional | None | $64.57 | $158.49 | $269.15 |
Oscar Health Setting Facility Modifier None Typical Low $977.24 Median $1,348.96 Typical High $1,737.80 | Facility | None | $977.24 | $1,348.96 | $1,737.80 |
United Setting Facility Modifier None Typical Low $79.43 Median $158.49 Typical High $1,778.28 | Facility | None | $79.43 | $158.49 | $1,778.28 |
United Setting Professional Modifier None Typical Low $67.61 Median $151.36 Typical High $295.12 | Professional | None | $67.61 | $151.36 | $295.12 |
5 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 $25.12 Median $45.71 Typical High $58.88 | Professional | 52 · Reduced service | $25.12 | $45.71 | $58.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.00 Median $18.20 Typical High $23.44 | Professional | 53 · Discontinued | $10.00 | $18.20 | $23.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $37.15 Median $67.61 Typical High $87.10 | Professional | 54 · Surgery only | $37.15 | $67.61 | $87.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.59 Median $13.49 Typical High $17.38 | Professional | 55 · Aftercare only | $7.59 | $13.49 | $17.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.01 Median $9.12 Typical High $11.75 | Professional | 56 · Pre-op care only | $5.01 | $9.12 | $11.75 |
Where Georgia sits
The same service costs 12.9 times more in Colorado than in Maine. 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 $2,408ME $187
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.