How much rates vary
Facilitymedian $1,413 · 10th to 90th $251 to $3,981Professionalmedian $191 · 10th to 90th $148 to $295
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 $162.18 Median $165.96 Typical High $5,248.07 | Facility | None | $162.18 | $165.96 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $162.18 Median $165.96 Typical High $213.80 | Professional | None | $162.18 | $165.96 | $213.80 |
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 $147.91 Median $190.55 Typical High $281.84 | Professional | None | $147.91 | $190.55 | $281.84 |
CareSource Setting Facility Modifier None Typical Low $131.83 Median $251.19 Typical High $1,348.96 | Facility | None | $131.83 | $251.19 | $1,348.96 |
CareSource Setting Professional Modifier None Typical Low $151.36 Median $218.78 Typical High $257.04 | Professional | None | $151.36 | $218.78 | $257.04 |
Cigna Setting Facility Modifier None Typical Low $275.42 Median $977.24 Typical High $1,659.59 | Facility | None | $275.42 | $977.24 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $263.03 Typical High $1,096.48 | Professional | None | $158.49 | $263.03 | $1,096.48 |
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 $165.96 Median $239.88 Typical High $323.59 | Professional | None | $165.96 | $239.88 | $323.59 |
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 $81.28 Median $83.18 Typical High $107.15 | Professional | 52 · Reduced service | $81.28 | $83.18 | $107.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $33.11 Typical High $42.66 | Professional | 53 · Discontinued | $32.36 | $33.11 | $42.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $123.03 Median $123.03 Typical High $158.49 | Professional | 54 · Surgery only | $123.03 | $123.03 | $158.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $24.55 Typical High $32.36 | Professional | 55 · Aftercare only | $24.55 | $24.55 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $16.60 Typical High $21.38 | Professional | 56 · Pre-op care only | $16.22 | $16.60 | $21.38 |
Where Kentucky 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.