How much rates vary
Facilitymedian $912 · 10th to 90th $513 to $5,012Professionalmedian $245 · 10th to 90th $186 to $398
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 $380.19 Median $5,011.87 Typical High $7,943.28 | Facility | None | $380.19 | $5,011.87 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $380.19 | Professional | None | $190.55 | $190.55 | $380.19 |
Ambetter Setting Professional Modifier None Typical Low $223.87 Median $223.87 Typical High $223.87 | Professional | None | $223.87 | $223.87 | $223.87 |
Anthem BCBS Setting Facility Modifier None Typical Low $512.86 Median $1,000.00 Typical High $5,011.87 | Facility | None | $512.86 | $1,000.00 | $5,011.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $190.55 Median $245.47 Typical High $389.05 | Professional | None | $190.55 | $245.47 | $389.05 |
Cigna Setting Facility Modifier None Typical Low $537.03 Median $977.24 Typical High $1,318.26 | Facility | None | $537.03 | $977.24 | $1,318.26 |
Cigna Setting Professional Modifier None Typical Low $194.98 Median $281.84 Typical High $436.52 | Professional | None | $194.98 | $281.84 | $436.52 |
Kaiser Permanente Setting Professional Modifier None Typical Low $154.88 Median $186.21 Typical High $354.81 | Professional | None | $154.88 | $186.21 | $354.81 |
United Setting Facility Modifier None Typical Low $501.19 Median $724.44 Typical High $3,801.89 | Facility | None | $501.19 | $724.44 | $3,801.89 |
United Setting Professional Modifier None Typical Low $181.97 Median $269.15 Typical High $467.74 | Professional | None | $181.97 | $269.15 | $467.74 |
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 $95.50 Median $95.50 Typical High $109.65 | Professional | 52 · Reduced service | $95.50 | $95.50 | $109.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $38.02 Typical High $43.65 | Professional | 53 · Discontinued | $38.02 | $38.02 | $43.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $141.25 Typical High $162.18 | Professional | 54 · Surgery only | $141.25 | $141.25 | $162.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $28.18 Typical High $32.36 | Professional | 55 · Aftercare only | $28.18 | $28.18 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $19.05 Typical High $21.88 | Professional | 56 · Pre-op care only | $19.05 | $19.05 | $21.88 |
Where Georgia sits
The same service costs 9.2 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 $4,822MT $526
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.