How much rates vary
Facilitymedian $3,388 · 10th to 90th $813 to $8,913Professionalmedian $1,000 · 10th to 90th $741 to $2,344
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 $1,698.24 Median $5,888.44 Typical High $13,489.63 | Facility | None | $1,698.24 | $5,888.44 | $13,489.63 |
Aetna Setting Professional Modifier None Typical Low $758.58 Median $933.25 Typical High $2,511.89 | Professional | None | $758.58 | $933.25 | $2,511.89 |
Ambetter Setting Professional Modifier None Typical Low $977.24 Median $977.24 Typical High $977.24 | Professional | None | $977.24 | $977.24 | $977.24 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,479.11 Median $3,467.37 Typical High $7,079.46 | Facility | None | $1,479.11 | $3,467.37 | $7,079.46 |
Anthem BCBS Setting Professional Modifier None Typical Low $758.58 Median $870.96 Typical High $1,621.81 | Professional | None | $758.58 | $870.96 | $1,621.81 |
BCBS Kansas City Setting Professional Modifier None Typical Low $616.60 Median $660.69 Typical High $954.99 | Professional | None | $616.60 | $660.69 | $954.99 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $851.14 Typical High $28,183.83 | Facility | None | $501.19 | $851.14 | $28,183.83 |
Cigna Setting Professional Modifier None Typical Low $724.44 Median $1,023.29 Typical High $2,238.72 | Professional | None | $724.44 | $1,023.29 | $2,238.72 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $2,511.89 Typical High $7,762.47 | Facility | None | $54.95 | $2,511.89 | $7,762.47 |
Medica Setting Professional Modifier None Typical Low $1,096.48 Median $1,905.46 Typical High $5,495.41 | Professional | None | $1,096.48 | $1,905.46 | $5,495.41 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $3,981.07 Typical High $7,943.28 | Facility | None | $1,258.93 | $3,981.07 | $7,943.28 |
United Setting Professional Modifier None Typical Low $870.96 Median $1,380.38 Typical High $2,344.23 | Professional | None | $870.96 | $1,380.38 | $2,344.23 |
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 $407.38 Median $467.74 Typical High $501.19 | Professional | 52 · Reduced service | $407.38 | $467.74 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $186.21 Typical High $199.53 | Professional | 53 · Discontinued | $162.18 | $186.21 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $707.95 Typical High $741.31 | Professional | 54 · Surgery only | $602.56 | $707.95 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $141.25 Typical High $147.91 | Professional | 55 · Aftercare only | $120.23 | $141.25 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $93.33 Typical High $100.00 | Professional | 56 · Pre-op care only | $81.28 | $93.33 | $100.00 |
Where Missouri sits
The same service costs 8.4 times more in Alabama than in Kentucky. 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
AL $15,863KY $1,884
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.