How much rates vary
Facilitymedian $1,514 · 10th to 90th $417 to $3,981Professionalmedian $309 · 10th to 90th $200 to $759
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 $288.40 Median $3,715.35 Typical High $6,309.57 | Facility | None | $288.40 | $3,715.35 | $6,309.57 |
Aetna Setting Professional Modifier None Typical Low $162.18 Median $251.19 Typical High $331.13 | Professional | None | $162.18 | $251.19 | $331.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $446.68 Median $1,621.81 Typical High $3,890.45 | Facility | None | $446.68 | $1,621.81 | $3,890.45 |
Anthem BCBS Setting Professional Modifier None Typical Low $199.53 Median $295.12 Typical High $446.68 | Professional | None | $199.53 | $295.12 | $446.68 |
BCBS Kansas City Setting Professional Modifier None Typical Low $204.17 Median $354.81 Typical High $398.11 | Professional | None | $204.17 | $354.81 | $398.11 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $1,412.54 Typical High $1,659.59 | Facility | None | $630.96 | $1,412.54 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $223.87 Median $323.59 Typical High $524.81 | Professional | None | $223.87 | $323.59 | $524.81 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $1,000.00 Typical High $3,090.30 | Facility | None | $54.95 | $1,000.00 | $3,090.30 |
Medica Setting Professional Modifier None Typical Low $281.84 Median $1,621.81 Typical High $2,511.89 | Professional | None | $281.84 | $1,621.81 | $2,511.89 |
United Setting Facility Modifier None Typical Low $562.34 Median $1,513.56 Typical High $3,235.94 | Facility | None | $562.34 | $1,513.56 | $3,235.94 |
United Setting Professional Modifier None Typical Low $204.17 Median $331.13 Typical High $575.44 | Professional | None | $204.17 | $331.13 | $575.44 |
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 $81.28 Median $125.89 Typical High $151.36 | Professional | 52 · Reduced service | $81.28 | $125.89 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $50.12 Typical High $61.66 | Professional | 53 · Discontinued | $33.11 | $50.12 | $61.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $123.03 Median $190.55 Typical High $229.09 | Professional | 54 · Surgery only | $123.03 | $190.55 | $229.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $38.02 Typical High $45.71 | Professional | 55 · Aftercare only | $24.55 | $38.02 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $25.12 Typical High $30.90 | Professional | 56 · Pre-op care only | $16.22 | $25.12 | $30.90 |
Where Missouri 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.