How much rates vary
Facilitymedian $891 · 10th to 90th $148 to $3,802Professionalmedian $389 · 10th to 90th $132 to $813
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 $141.25 Median $389.05 Typical High $776.25 | Facility | None | $141.25 | $389.05 | $776.25 |
Aetna Setting Professional Modifier None Typical Low $128.82 Median $380.19 Typical High $630.96 | Professional | None | $128.82 | $380.19 | $630.96 |
Ambetter Setting Professional Modifier None Typical Low $158.49 Median $165.96 Typical High $660.69 | Professional | None | $158.49 | $165.96 | $660.69 |
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 $131.83 Median $426.58 Typical High $741.31 | Professional | None | $131.83 | $426.58 | $741.31 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $194.98 Median $645.65 Typical High $1,096.48 | Professional | 50 · Both sides | $194.98 | $645.65 | $1,096.48 |
CareSource Setting Facility Modifier None Typical Low $138.04 Median $199.53 Typical High $1,202.26 | Facility | None | $138.04 | $199.53 | $1,202.26 |
CareSource Setting Professional Modifier None Typical Low $177.83 Median $416.87 Typical High $588.84 | Professional | None | $177.83 | $416.87 | $588.84 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $776.25 Typical High $912.01 | Facility | None | $34.67 | $776.25 | $912.01 |
Cigna Setting Professional Modifier None Typical Low $144.54 Median $446.68 Typical High $2,754.23 | Professional | None | $144.54 | $446.68 | $2,754.23 |
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 $2,754.23 | Facility | None | $457.09 | $794.33 | $2,754.23 |
United Setting Professional Modifier None Typical Low $141.25 Median $478.63 Typical High $954.99 | Professional | None | $141.25 | $478.63 | $954.99 |
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 $64.57 Median $87.10 Typical High $316.23 | Facility | 52 · Reduced service | $64.57 | $87.10 | $316.23 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $25.70 Median $34.67 Typical High $125.89 | Facility | 53 · Discontinued | $25.70 | $34.67 | $125.89 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $97.72 Median $128.82 Typical High $478.63 | Facility | 54 · Surgery only | $97.72 | $128.82 | $478.63 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $19.50 Median $25.70 Typical High $95.50 | Facility | 55 · Aftercare only | $19.50 | $25.70 | $95.50 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $12.88 Median $17.38 Typical High $63.10 | Facility | 56 · Pre-op care only | $12.88 | $17.38 | $63.10 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $64.57 Median $107.15 Typical High $218.78 | Professional | 52 · Reduced service | $64.57 | $107.15 | $218.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $42.66 Typical High $87.10 | Professional | 53 · Discontinued | $25.70 | $42.66 | $87.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $97.72 Median $162.18 Typical High $331.13 | Professional | 54 · Surgery only | $97.72 | $162.18 | $331.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $32.36 Typical High $66.07 | Professional | 55 · Aftercare only | $19.50 | $32.36 | $66.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $21.38 Typical High $43.65 | Professional | 56 · Pre-op care only | $12.88 | $21.38 | $43.65 |
Where Kentucky sits
The same service costs 4.5 times more in Colorado 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
CO $4,866MD $1,088
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.