How much rates vary
Facilitymedian $741 · 10th to 90th $204 to $3,981Professionalmedian $204 · 10th to 90th $162 to $347
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 $194.98 Median $257.04 Typical High $5,248.07 | Facility | None | $194.98 | $257.04 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $199.53 Median $234.42 Typical High $257.04 | Professional | None | $199.53 | $234.42 | $257.04 |
Anthem BCBS Setting Facility Modifier None Typical Low $758.58 Median $5,011.87 Typical High $11,220.18 | Facility | None | $758.58 | $5,011.87 | $11,220.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $162.18 Median $194.98 Typical High $257.04 | Professional | None | $162.18 | $194.98 | $257.04 |
CareSource Setting Facility Modifier None Typical Low $208.93 Median $758.58 Typical High $1,258.93 | Facility | None | $208.93 | $758.58 | $1,258.93 |
CareSource Setting Professional Modifier None Typical Low $223.87 Median $302.00 Typical High $371.54 | Professional | None | $223.87 | $302.00 | $371.54 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $446.68 Typical High $1,047.13 | Facility | None | $34.67 | $446.68 | $1,047.13 |
Cigna Setting Professional Modifier None Typical Low $213.80 Median $281.84 Typical High $1,047.13 | Professional | None | $213.80 | $281.84 | $1,047.13 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $93.33 | Professional | None | $33.11 | $33.11 | $93.33 |
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 $223.87 Median $269.15 Typical High $407.38 | Professional | None | $223.87 | $269.15 | $407.38 |
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 $100.00 Median $109.65 Typical High $128.82 | Professional | 52 · Reduced service | $100.00 | $109.65 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $39.81 Median $43.65 Typical High $51.29 | Professional | 53 · Discontinued | $39.81 | $43.65 | $51.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $151.36 Median $162.18 Typical High $190.55 | Professional | 54 · Surgery only | $151.36 | $162.18 | $190.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $32.36 Typical High $38.02 | Professional | 55 · Aftercare only | $30.20 | $32.36 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $21.88 Typical High $25.70 | Professional | 56 · Pre-op care only | $19.95 | $21.88 | $25.70 |
Where Kentucky sits
The same service costs 6.2 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 $4,689MT $752
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.