How much rates vary
Facilitymedian $1,072 · 10th to 90th $126 to $2,818Professionalmedian $191 · 10th to 90th $95 to $407
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 $85.11 Median $204.17 Typical High $416.87 | Facility | None | $85.11 | $204.17 | $416.87 |
Aetna Setting Professional Modifier None Typical Low $85.11 Median $204.17 Typical High $426.58 | Professional | None | $85.11 | $204.17 | $426.58 |
Ambetter Setting Professional Modifier None Typical Low $75.86 Median $81.28 Typical High $95.50 | Professional | None | $75.86 | $81.28 | $95.50 |
Anthem BCBS Setting Facility Modifier None Typical Low $602.56 Median $1,698.24 Typical High $2,884.03 | Facility | None | $602.56 | $1,698.24 | $2,884.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $112.20 Median $186.21 Typical High $407.38 | Professional | None | $112.20 | $186.21 | $407.38 |
CareSource Setting Facility Modifier None Typical Low $75.86 Median $109.65 Typical High $2,691.53 | Facility | None | $75.86 | $109.65 | $2,691.53 |
CareSource Setting Professional Modifier None Typical Low $85.11 Median $154.88 Typical High $263.03 | Professional | None | $85.11 | $154.88 | $263.03 |
Cigna Setting Facility Modifier None Typical Low $138.04 Median $1,318.26 Typical High $1,949.84 | Facility | None | $138.04 | $1,318.26 | $1,949.84 |
Cigna Setting Professional Modifier None Typical Low $109.65 Median $269.15 Typical High $1,905.46 | Professional | None | $109.65 | $269.15 | $1,905.46 |
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 $323.59 Median $588.84 Typical High $2,511.89 | Facility | None | $323.59 | $588.84 | $2,511.89 |
United Setting Professional Modifier None Typical Low $147.91 Median $229.09 Typical High $416.87 | Professional | None | $147.91 | $229.09 | $416.87 |
10 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 Facility Modifier 52 · Reduced service Typical Low $42.66 Median $77.62 Typical High $186.21 | Facility | 52 · Reduced service | $42.66 | $77.62 | $186.21 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $16.98 Median $31.62 Typical High $74.13 | Facility | 53 · Discontinued | $16.98 | $31.62 | $74.13 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $64.57 Median $117.49 Typical High $281.84 | Facility | 54 · Surgery only | $64.57 | $117.49 | $281.84 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $12.88 Median $23.44 Typical High $56.23 | Facility | 55 · Aftercare only | $12.88 | $23.44 | $56.23 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $8.51 Median $15.85 Typical High $37.15 | Facility | 56 · Pre-op care only | $8.51 | $15.85 | $37.15 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $42.66 Median $100.00 Typical High $158.49 | Professional | 52 · Reduced service | $42.66 | $100.00 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $40.74 Typical High $64.57 | Professional | 53 · Discontinued | $16.98 | $40.74 | $64.57 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $64.57 Median $151.36 Typical High $239.88 | Professional | 54 · Surgery only | $64.57 | $151.36 | $239.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $30.20 Typical High $47.86 | Professional | 55 · Aftercare only | $12.88 | $30.20 | $47.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $20.42 Typical High $32.36 | Professional | 56 · Pre-op care only | $8.51 | $20.42 | $32.36 |
Where Kentucky sits
The same service costs 10.4 times more in Colorado than in North Dakota. 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 $4,594ND $443
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.