How much rates vary
Facilitymedian $1,380 · 10th to 90th $204 to $3,890Professionalmedian $282 · 10th to 90th $87 to $692
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 $109.65 Median $295.12 Typical High $794.33 | Facility | None | $109.65 | $295.12 | $794.33 |
Aetna Setting Professional Modifier None Typical Low $107.15 Median $269.15 Typical High $524.81 | Professional | None | $107.15 | $269.15 | $524.81 |
Ambetter Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $186.21 | Professional | None | $158.49 | $158.49 | $186.21 |
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 $77.62 Median $281.84 Typical High $575.44 | Professional | None | $77.62 | $281.84 | $575.44 |
CareSource Setting Facility Modifier None Typical Low $117.49 Median $190.55 Typical High $1,202.26 | Facility | None | $117.49 | $190.55 | $1,202.26 |
CareSource Setting Professional Modifier None Typical Low $109.65 Median $162.18 Typical High $194.98 | Professional | None | $109.65 | $162.18 | $194.98 |
Cigna Setting Facility Modifier None Typical Low $204.17 Median $851.14 Typical High $1,659.59 | Facility | None | $204.17 | $851.14 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $338.84 Typical High $2,344.23 | Professional | None | $120.23 | $338.84 | $2,344.23 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $97.72 | Professional | None | $33.11 | $33.11 | $97.72 |
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 $123.03 Median $309.03 Typical High $891.25 | Professional | None | $123.03 | $309.03 | $891.25 |
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 $54.95 Median $134.90 Typical High $186.21 | Facility | 52 · Reduced service | $54.95 | $134.90 | $186.21 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $21.88 Median $54.95 Typical High $74.13 | Facility | 53 · Discontinued | $21.88 | $54.95 | $74.13 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $83.18 Median $204.17 Typical High $275.42 | Facility | 54 · Surgery only | $83.18 | $204.17 | $275.42 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $16.60 Median $40.74 Typical High $54.95 | Facility | 55 · Aftercare only | $16.60 | $40.74 | $54.95 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $10.96 Median $26.92 Typical High $37.15 | Facility | 56 · Pre-op care only | $10.96 | $26.92 | $37.15 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $54.95 Median $134.90 Typical High $186.21 | Professional | 52 · Reduced service | $54.95 | $134.90 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $54.95 Typical High $74.13 | Professional | 53 · Discontinued | $21.88 | $54.95 | $74.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $204.17 Typical High $275.42 | Professional | 54 · Surgery only | $83.18 | $204.17 | $275.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $40.74 Typical High $54.95 | Professional | 55 · Aftercare only | $16.60 | $40.74 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $26.92 Typical High $37.15 | Professional | 56 · Pre-op care only | $10.96 | $26.92 | $37.15 |
Where Kentucky sits
The same service costs 5.1 times more in Colorado than in North Dakota. 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 $4,353ND $853
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.