How much rates vary
Facilitymedian $1,585 · 10th to 90th $550 to $5,370Professionalmedian $347 · 10th to 90th $257 to $603
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 $269.15 Median $5,011.87 Typical High $7,943.28 | Facility | None | $269.15 | $5,011.87 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $269.15 Median $288.40 Typical High $794.33 | Professional | None | $269.15 | $288.40 | $794.33 |
Ambetter Setting Professional Modifier None Typical Low $316.23 Median $416.87 Typical High $416.87 | Professional | None | $316.23 | $416.87 | $416.87 |
Anthem BCBS Setting Facility Modifier None Typical Low $512.86 Median $1,071.52 Typical High $5,754.40 | Facility | None | $512.86 | $1,071.52 | $5,754.40 |
Anthem BCBS Setting Professional Modifier None Typical Low $251.19 Median $346.74 Typical High $549.54 | Professional | None | $251.19 | $346.74 | $549.54 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $1,949.84 Typical High $2,454.71 | Facility | None | $524.81 | $1,949.84 | $2,454.71 |
Cigna Setting Professional Modifier None Typical Low $269.15 Median $407.38 Typical High $645.65 | Professional | None | $269.15 | $407.38 | $645.65 |
Kaiser Permanente Setting Professional Modifier None Typical Low $218.78 Median $263.03 Typical High $436.52 | Professional | None | $218.78 | $263.03 | $436.52 |
United Setting Facility Modifier None Typical Low $851.14 Median $1,479.11 Typical High $5,011.87 | Facility | None | $851.14 | $1,479.11 | $5,011.87 |
United Setting Professional Modifier None Typical Low $257.04 Median $398.11 Typical High $707.95 | Professional | None | $257.04 | $398.11 | $707.95 |
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 $134.90 Median $134.90 Typical High $151.36 | Professional | 52 · Reduced service | $134.90 | $134.90 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $53.70 Typical High $61.66 | Professional | 53 · Discontinued | $53.70 | $53.70 | $61.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $199.53 Median $199.53 Typical High $229.09 | Professional | 54 · Surgery only | $199.53 | $199.53 | $229.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $39.81 Typical High $45.71 | Professional | 55 · Aftercare only | $39.81 | $39.81 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $26.92 Typical High $30.20 | Professional | 56 · Pre-op care only | $26.92 | $26.92 | $30.20 |
Where Georgia sits
The same service costs 8.5 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 $6,252MT $735
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.