How much rates vary
Facilitymedian $1,122 · 10th to 90th $575 to $1,950Professionalmedian $186 · 10th to 90th $145 to $263
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 $616.60 Median $1,122.02 Typical High $1,905.46 | Facility | None | $616.60 | $1,122.02 | $1,905.46 |
Aetna Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $263.03 | Professional | None | $263.03 | $263.03 | $263.03 |
BCBS Setting Facility Modifier None Typical Low $1,096.48 Median $1,122.02 Typical High $1,122.02 | Facility | None | $1,096.48 | $1,122.02 | $1,122.02 |
BCBS Setting Professional Modifier 32 · Mandated service Typical Low $208.93 Median $245.47 Typical High $338.84 | Professional | 32 · Mandated service | $208.93 | $245.47 | $338.84 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $831.76 Typical High $1,096.48 | Facility | None | $489.78 | $831.76 | $1,096.48 |
Cigna Setting Professional Modifier None Typical Low $154.88 Median $181.97 Typical High $239.88 | Professional | None | $154.88 | $181.97 | $239.88 |
United Setting Facility Modifier None Typical Low $467.74 Median $1,000.00 Typical High $3,162.28 | Facility | None | $467.74 | $1,000.00 | $3,162.28 |
United Setting Professional Modifier None Typical Low $120.23 Median $154.88 Typical High $234.42 | Professional | None | $120.23 | $154.88 | $234.42 |
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 $131.83 Median $131.83 Typical High $131.83 | Professional | 52 · Reduced service | $131.83 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $52.48 Typical High $52.48 | Professional | 53 · Discontinued | $52.48 | $52.48 | $52.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $199.53 Median $199.53 Typical High $199.53 | Professional | 54 · Surgery only | $199.53 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $39.81 Typical High $39.81 | Professional | 55 · Aftercare only | $39.81 | $39.81 | $39.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $26.30 Typical High $26.30 | Professional | 56 · Pre-op care only | $26.30 | $26.30 | $26.30 |
Where Alabama sits
The same service costs 9.9 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 $4,594MT $464
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.