How much rates vary
Facilitymedian $1,413 · 10th to 90th $234 to $3,981Professionalmedian $166 · 10th to 90th $129 to $269
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 $151.36 Median $154.88 Typical High $2,290.87 | Facility | None | $151.36 | $154.88 | $2,290.87 |
Aetna Setting Professional Modifier None Typical Low $151.36 Median $154.88 Typical High $239.88 | Professional | None | $151.36 | $154.88 | $239.88 |
Ambetter Setting Professional Modifier None Typical Low $79.43 Median $79.43 Typical High $79.43 | Professional | None | $79.43 | $79.43 | $79.43 |
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 $128.82 Median $165.96 Typical High $245.47 | Professional | None | $128.82 | $165.96 | $245.47 |
CareSource Setting Facility Modifier None Typical Low $123.03 Median $234.42 Typical High $1,348.96 | Facility | None | $123.03 | $234.42 | $1,348.96 |
CareSource Setting Professional Modifier None Typical Low $158.49 Median $204.17 Typical High $239.88 | Professional | None | $158.49 | $204.17 | $239.88 |
Cigna Setting Facility Modifier None Typical Low $239.88 Median $977.24 Typical High $1,659.59 | Facility | None | $239.88 | $977.24 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $147.91 Median $223.87 Typical High $977.24 | Professional | None | $147.91 | $223.87 | $977.24 |
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 $2,454.71 | Facility | None | $457.09 | $794.33 | $2,454.71 |
United Setting Professional Modifier None Typical Low $147.91 Median $208.93 Typical High $281.84 | Professional | None | $147.91 | $208.93 | $281.84 |
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 $75.86 Median $77.62 Typical High $95.50 | Professional | 52 · Reduced service | $75.86 | $77.62 | $95.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $30.90 Typical High $38.02 | Professional | 53 · Discontinued | $30.20 | $30.90 | $38.02 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $114.82 Typical High $141.25 | Professional | 54 · Surgery only | $114.82 | $114.82 | $141.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $22.91 Typical High $28.18 | Professional | 55 · Aftercare only | $22.91 | $22.91 | $28.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $15.49 Typical High $19.05 | Professional | 56 · Pre-op care only | $15.14 | $15.49 | $19.05 |
Where Kentucky 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.