How much rates vary
Facilitymedian $575 · 10th to 90th $71 to $3,890Professionalmedian $115 · 10th to 90th $60 to $302
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 $52.48 Median $138.04 Typical High $6,309.57 | Facility | None | $52.48 | $138.04 | $6,309.57 |
Aetna Setting Professional Modifier None Typical Low $43.65 Median $83.18 Typical High $173.78 | Professional | None | $43.65 | $83.18 | $173.78 |
Ambetter Setting Professional Modifier None Typical Low $46.77 Median $74.13 Typical High $97.72 | Professional | None | $46.77 | $74.13 | $97.72 |
Anthem BCBS Setting Facility Modifier None Typical Low $151.36 Median $1,621.81 Typical High $3,890.45 | Facility | None | $151.36 | $1,621.81 | $3,890.45 |
Anthem BCBS Setting Professional Modifier None Typical Low $75.86 Median $123.03 Typical High $181.97 | Professional | None | $75.86 | $123.03 | $181.97 |
BCBS Kansas City Setting Professional Modifier None Typical Low $60.26 Median $134.90 Typical High $151.36 | Professional | None | $60.26 | $134.90 | $151.36 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $66.07 Typical High $66.07 | Facility | None | $50.12 | $66.07 | $66.07 |
Cigna Setting Professional Modifier None Typical Low $60.26 Median $104.71 Typical High $177.83 | Professional | None | $60.26 | $104.71 | $177.83 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $263.03 Typical High $1,380.38 | Facility | None | $54.95 | $263.03 | $1,380.38 |
Medica Setting Professional Modifier None Typical Low $104.71 Median $501.19 Typical High $933.25 | Professional | None | $104.71 | $501.19 | $933.25 |
United Setting Facility Modifier None Typical Low $123.03 Median $602.56 Typical High $2,137.96 | Facility | None | $123.03 | $602.56 | $2,137.96 |
United Setting Professional Modifier None Typical Low $56.23 Median $104.71 Typical High $194.98 | Professional | None | $56.23 | $104.71 | $194.98 |
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 $21.38 Median $41.69 Typical High $50.12 | Professional | 52 · Reduced service | $21.38 | $41.69 | $50.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.71 Median $16.60 Typical High $19.95 | Professional | 53 · Discontinued | $8.71 | $16.60 | $19.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $32.36 Median $63.10 Typical High $75.86 | Professional | 54 · Surgery only | $32.36 | $63.10 | $75.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.46 Median $12.59 Typical High $15.14 | Professional | 55 · Aftercare only | $6.46 | $12.59 | $15.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $8.32 Typical High $10.00 | Professional | 56 · Pre-op care only | $4.37 | $8.32 | $10.00 |
Where Missouri 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.