How much rates vary
Facilitymedian $1,778 · 10th to 90th $631 to $7,079Professionalmedian $295 · 10th to 90th $155 to $437
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 $173.78 Median $8,709.64 Typical High $20,417.38 | Facility | None | $173.78 | $8,709.64 | $20,417.38 |
Aetna Setting Professional Modifier None Typical Low $173.78 Median $257.04 Typical High $346.74 | Professional | None | $173.78 | $257.04 | $346.74 |
Ambetter Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $257.04 | Professional | None | $154.88 | $154.88 | $257.04 |
BCBS Setting Facility Modifier None Typical Low $851.14 Median $2,137.96 Typical High $6,760.83 | Facility | None | $851.14 | $2,137.96 | $6,760.83 |
BCBS Setting Professional Modifier None Typical Low $141.25 Median $229.09 Typical High $316.23 | Professional | None | $141.25 | $229.09 | $316.23 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,380.38 Typical High $2,238.72 | Facility | None | $602.56 | $1,380.38 | $2,238.72 |
Cigna Setting Professional Modifier None Typical Low $169.82 Median $281.84 Typical High $436.52 | Professional | None | $169.82 | $281.84 | $436.52 |
Medcost Setting Facility Modifier None Typical Low $173.78 Median $630.96 Typical High $1,000.00 | Facility | None | $173.78 | $630.96 | $1,000.00 |
Medcost Setting Professional Modifier None Typical Low $281.84 Median $346.74 Typical High $398.11 | Professional | None | $281.84 | $346.74 | $398.11 |
Molina Setting Professional Modifier None Typical Low $309.03 Median $398.11 Typical High $575.44 | Professional | None | $309.03 | $398.11 | $575.44 |
United Setting Facility Modifier None Typical Low $512.86 Median $1,479.11 Typical High $8,912.51 | Facility | None | $512.86 | $1,479.11 | $8,912.51 |
United Setting Professional Modifier None Typical Low $131.83 Median $239.88 Typical High $407.38 | Professional | None | $131.83 | $239.88 | $407.38 |
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 $87.10 Median $117.49 Typical High $169.82 | Professional | 52 · Reduced service | $87.10 | $117.49 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $46.77 Typical High $69.18 | Professional | 53 · Discontinued | $34.67 | $46.77 | $69.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $131.83 Median $173.78 Typical High $257.04 | Professional | 54 · Surgery only | $131.83 | $173.78 | $257.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $34.67 Typical High $51.29 | Professional | 55 · Aftercare only | $26.30 | $34.67 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $23.44 Typical High $34.67 | Professional | 56 · Pre-op care only | $17.38 | $23.44 | $34.67 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $141.25 Median $186.21 Typical High $263.03 | Professional | 51 · Multiple procedures | $141.25 | $186.21 | $263.03 |
Where South Carolina sits
The same service costs 8.3 times more in Colorado 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
CO $5,550MT $667
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.