How much rates vary
Facilitymedian $661 · 10th to 90th $105 to $3,890Professionalmedian $186 · 10th to 90th $100 to $871
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 $154.88 Median $3,162.28 Typical High $6,309.57 | Facility | None | $154.88 | $3,162.28 | $6,309.57 |
Aetna Setting Professional Modifier None Typical Low $69.18 Median $125.89 Typical High $251.19 | Professional | None | $69.18 | $125.89 | $251.19 |
Ambetter Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $89.13 | Professional | None | $89.13 | $89.13 | $89.13 |
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 $123.03 Median $194.98 Typical High $288.40 | Professional | None | $123.03 | $194.98 | $288.40 |
BCBS Kansas City Setting Professional Modifier None Typical Low $95.50 Median $204.17 Typical High $234.42 | Professional | None | $95.50 | $204.17 | $234.42 |
Cigna Setting Facility Modifier None Typical Low $58.88 Median $114.82 Typical High $162.18 | Facility | None | $58.88 | $114.82 | $162.18 |
Cigna Setting Professional Modifier None Typical Low $93.33 Median $165.96 Typical High $275.42 | Professional | None | $93.33 | $165.96 | $275.42 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $323.59 Typical High $1,380.38 | Facility | None | $54.95 | $323.59 | $1,380.38 |
Medica Setting Professional Modifier None Typical Low $158.49 Median $870.96 Typical High $1,479.11 | Professional | None | $158.49 | $870.96 | $1,479.11 |
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 $91.20 Median $162.18 Typical High $309.03 | Professional | None | $91.20 | $162.18 | $309.03 |
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 $34.67 Median $63.10 Typical High $75.86 | Professional | 52 · Reduced service | $34.67 | $63.10 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $25.12 Typical High $30.90 | Professional | 53 · Discontinued | $13.80 | $25.12 | $30.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $52.48 Median $95.50 Typical High $114.82 | Professional | 54 · Surgery only | $52.48 | $95.50 | $114.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $19.05 Typical High $22.91 | Professional | 55 · Aftercare only | $10.47 | $19.05 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $12.59 Typical High $15.49 | Professional | 56 · Pre-op care only | $6.92 | $12.59 | $15.49 |
Where Missouri sits
The same service costs 11.6 times more in Hawaii than in Maryland. 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
HI $3,027MD $261
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.