How much rates vary
Facilitymedian $2,042 · 10th to 90th $151 to $16,596Professionalmedian $617 · 10th to 90th $135 to $1,514
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 $707.95 Median $3,715.35 Typical High $14,125.38 | Facility | None | $707.95 | $3,715.35 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $151.36 Median $616.60 Typical High $1,174.90 | Professional | None | $151.36 | $616.60 | $1,174.90 |
Ambetter Setting Professional Modifier None Typical Low $125.89 Median $147.91 Typical High $512.86 | Professional | None | $125.89 | $147.91 | $512.86 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,412.54 Median $5,888.44 Typical High $17,782.79 | Facility | None | $1,412.54 | $5,888.44 | $17,782.79 |
Anthem BCBS Setting Professional Modifier None Typical Low $131.83 Median $512.86 Typical High $933.25 | Professional | None | $131.83 | $512.86 | $933.25 |
BCBS Kansas City Setting Professional Modifier None Typical Low $134.90 Median $562.34 Typical High $776.25 | Professional | None | $134.90 | $562.34 | $776.25 |
Cigna Setting Facility Modifier None Typical Low $575.44 Median $2,691.53 Typical High $15,135.61 | Facility | None | $575.44 | $2,691.53 | $15,135.61 |
Cigna Setting Professional Modifier None Typical Low $141.25 Median $363.08 Typical High $1,258.93 | Professional | None | $141.25 | $363.08 | $1,258.93 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $380.19 Typical High $2,041.74 | Facility | None | $54.95 | $380.19 | $2,041.74 |
Medica Setting Professional Modifier None Typical Low $977.24 Median $2,187.76 Typical High $4,265.80 | Professional | None | $977.24 | $2,187.76 | $4,265.80 |
United Setting Facility Modifier None Typical Low $123.03 Median $676.08 Typical High $15,848.93 | Facility | None | $123.03 | $676.08 | $15,848.93 |
United Setting Professional Modifier None Typical Low $181.97 Median $630.96 Typical High $1,584.89 | Professional | None | $181.97 | $630.96 | $1,584.89 |
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 $75.86 Median $123.03 Typical High $354.81 | Professional | 52 · Reduced service | $75.86 | $123.03 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $48.98 Typical High $141.25 | Professional | 53 · Discontinued | $30.20 | $48.98 | $141.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $112.20 Median $186.21 Typical High $537.03 | Professional | 54 · Surgery only | $112.20 | $186.21 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $37.15 Typical High $107.15 | Professional | 55 · Aftercare only | $22.91 | $37.15 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $24.55 Typical High $70.79 | Professional | 56 · Pre-op care only | $15.14 | $24.55 | $70.79 |
Where Missouri sits
The same service costs 17.4 times more in Alabama 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
AL $9,157MT $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.