How much rates vary
Facilitymedian $1,349 · 10th to 90th $214 to $3,890Professionalmedian $263 · 10th to 90th $182 to $427
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 $190.55 Median $281.84 Typical High $794.33 | Facility | None | $190.55 | $281.84 | $794.33 |
Aetna Setting Professional Modifier None Typical Low $190.55 Median $281.84 Typical High $354.81 | Professional | None | $190.55 | $281.84 | $354.81 |
Anthem BCBS Setting Facility Modifier None Typical Low $724.44 Median $1,995.26 Typical High $4,265.80 | Facility | None | $724.44 | $1,995.26 | $4,265.80 |
Anthem BCBS Setting Professional Modifier None Typical Low $173.78 Median $234.42 Typical High $316.23 | Professional | None | $173.78 | $234.42 | $316.23 |
CareSource Setting Facility Modifier None Typical Low $199.53 Median $331.13 Typical High $1,659.59 | Facility | None | $199.53 | $331.13 | $1,659.59 |
CareSource Setting Professional Modifier None Typical Low $181.97 Median $288.40 Typical High $338.84 | Professional | None | $181.97 | $288.40 | $338.84 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $398.11 Typical High $1,348.96 | Facility | None | $34.67 | $398.11 | $1,348.96 |
Cigna Setting Professional Modifier None Typical Low $208.93 Median $316.23 Typical High $1,737.80 | Professional | None | $208.93 | $316.23 | $1,737.80 |
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 $457.09 Median $794.33 Typical High $2,454.71 | Facility | None | $457.09 | $794.33 | $2,454.71 |
United Setting Professional Modifier None Typical Low $204.17 Median $295.12 Typical High $467.74 | Professional | None | $204.17 | $295.12 | $467.74 |
10 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 Facility Modifier 52 · Reduced service Typical Low $95.50 Median $107.15 Typical High $158.49 | Facility | 52 · Reduced service | $95.50 | $107.15 | $158.49 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $38.02 Median $42.66 Typical High $63.10 | Facility | 53 · Discontinued | $38.02 | $42.66 | $63.10 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $141.25 Median $162.18 Typical High $239.88 | Facility | 54 · Surgery only | $141.25 | $162.18 | $239.88 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $28.18 Median $32.36 Typical High $47.86 | Facility | 55 · Aftercare only | $28.18 | $32.36 | $47.86 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $19.05 Median $21.38 Typical High $31.62 | Facility | 56 · Pre-op care only | $19.05 | $21.38 | $31.62 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $95.50 Median $123.03 Typical High $158.49 | Professional | 52 · Reduced service | $95.50 | $123.03 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $50.12 Typical High $63.10 | Professional | 53 · Discontinued | $38.02 | $50.12 | $63.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $186.21 Typical High $239.88 | Professional | 54 · Surgery only | $141.25 | $186.21 | $239.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $37.15 Typical High $47.86 | Professional | 55 · Aftercare only | $28.18 | $37.15 | $47.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $24.55 Typical High $31.62 | Professional | 56 · Pre-op care only | $19.05 | $24.55 | $31.62 |
Where Kentucky sits
The same service costs 6.1 times more in Michigan 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
MI $4,783MT $790
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.