How much rates vary
Facilitymedian $1,660 · 10th to 90th $309 to $4,169Professionalmedian $269 · 10th to 90th $209 to $427
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 $239.88 Median $245.47 Typical High $2,290.87 | Facility | None | $239.88 | $245.47 | $2,290.87 |
Aetna Setting Professional Modifier None Typical Low $239.88 Median $245.47 Typical High $426.58 | Professional | None | $239.88 | $245.47 | $426.58 |
Ambetter Setting Professional Modifier None Typical Low $123.03 Median $123.03 Typical High $275.42 | Professional | None | $123.03 | $123.03 | $275.42 |
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 $208.93 Median $269.15 Typical High $407.38 | Professional | None | $208.93 | $269.15 | $407.38 |
CareSource Setting Facility Modifier None Typical Low $223.87 Median $363.08 Typical High $2,691.53 | Facility | None | $223.87 | $363.08 | $2,691.53 |
CareSource Setting Professional Modifier None Typical Low $229.09 Median $323.59 Typical High $380.19 | Professional | None | $229.09 | $323.59 | $380.19 |
Cigna Setting Facility Modifier None Typical Low $371.54 Median $1,659.59 Typical High $2,041.74 | Facility | None | $371.54 | $1,659.59 | $2,041.74 |
Cigna Setting Professional Modifier None Typical Low $234.42 Median $363.08 Typical High $1,621.81 | Professional | None | $234.42 | $363.08 | $1,621.81 |
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 $707.95 Median $1,174.90 Typical High $3,890.45 | Facility | None | $707.95 | $1,174.90 | $3,890.45 |
United Setting Professional Modifier None Typical Low $239.88 Median $338.84 Typical High $457.09 | Professional | None | $239.88 | $338.84 | $457.09 |
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 $120.23 Median $120.23 Typical High $151.36 | Professional | 52 · Reduced service | $120.23 | $120.23 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $48.98 Typical High $61.66 | Professional | 53 · Discontinued | $47.86 | $48.98 | $61.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $181.97 Median $181.97 Typical High $229.09 | Professional | 54 · Surgery only | $181.97 | $181.97 | $229.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $36.31 Typical High $45.71 | Professional | 55 · Aftercare only | $36.31 | $36.31 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $24.55 Typical High $30.20 | Professional | 56 · Pre-op care only | $23.99 | $24.55 | $30.20 |
Where Kentucky 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.