How much rates vary
Facilitymedian $209 · 10th to 90th $65 to $759Professionalmedian $112 · 10th to 90th $58 to $282
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 $64.57 Median $114.82 Typical High $870.96 | Facility | None | $64.57 | $114.82 | $870.96 |
Aetna Setting Professional Modifier None Typical Low $57.54 Median $104.71 Typical High $162.18 | Professional | None | $57.54 | $104.71 | $162.18 |
CareSource Setting Professional Modifier None Typical Low $69.18 Median $104.71 Typical High $125.89 | Professional | None | $69.18 | $104.71 | $125.89 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $34.67 Typical High $102.33 | Facility | None | $34.67 | $34.67 | $102.33 |
Cigna Setting Professional Modifier None Typical Low $61.66 Median $112.20 Typical High $281.84 | Professional | None | $61.66 | $112.20 | $281.84 |
Highmark BCBS Setting Facility Modifier None Typical Low $218.78 Median $416.87 Typical High $676.08 | Facility | None | $218.78 | $416.87 | $676.08 |
United Setting Facility Modifier None Typical Low $100.00 Median $131.83 Typical High $562.34 | Facility | None | $100.00 | $131.83 | $562.34 |
United Setting Professional Modifier None Typical Low $72.44 Median $141.25 Typical High $346.74 | Professional | None | $72.44 | $141.25 | $346.74 |
6 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 $28.84 Median $29.51 Typical High $52.48 | Professional | 52 · Reduced service | $28.84 | $29.51 | $52.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.48 Median $11.75 Typical High $20.89 | Professional | 53 · Discontinued | $11.48 | $11.75 | $20.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $43.65 Median $43.65 Typical High $79.43 | Professional | 54 · Surgery only | $43.65 | $43.65 | $79.43 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.71 Median $14.79 Typical High $15.85 | Professional | 55 · Aftercare only | $8.71 | $14.79 | $15.85 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.75 Median $9.77 Typical High $10.47 | Professional | 56 · Pre-op care only | $5.75 | $9.77 | $10.47 |
Highmark BCBS Setting Professional Modifier 59 · Distinct service Typical Low $123.03 Median $123.03 Typical High $123.03 | Professional | 59 · Distinct service | $123.03 | $123.03 | $123.03 |
Where West Virginia 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.