How much rates vary
Facilitymedian $4,898 · 10th to 90th $1,096 to $14,791Professionalmedian $3,802 · 10th to 90th $437 to $10,715
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 $812.83 Median $5,495.41 Typical High $8,912.51 | Facility | None | $812.83 | $5,495.41 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $446.68 Median $3,548.13 Typical High $5,623.41 | Professional | None | $446.68 | $3,548.13 | $5,623.41 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,318.26 Median $3,801.89 Typical High $11,220.18 | Facility | None | $1,318.26 | $3,801.89 | $11,220.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $436.52 Median $1,905.46 Typical High $6,606.93 | Professional | None | $436.52 | $1,905.46 | $6,606.93 |
BCBS Kansas City Setting Professional Modifier None Typical Low $389.05 Median $4,168.69 Typical High $5,754.40 | Professional | None | $389.05 | $4,168.69 | $5,754.40 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $7,585.78 Typical High $24,547.09 | Facility | None | $741.31 | $7,585.78 | $24,547.09 |
Cigna Setting Professional Modifier None Typical Low $407.38 Median $1,380.38 Typical High $9,549.93 | Professional | None | $407.38 | $1,380.38 | $9,549.93 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $4,466.84 Typical High $16,595.87 | Facility | None | $54.95 | $4,466.84 | $16,595.87 |
Medica Setting Professional Modifier None Typical Low $6,165.95 Median $16,982.44 Typical High $33,113.11 | Professional | None | $6,165.95 | $16,982.44 | $33,113.11 |
United Setting Facility Modifier None Typical Low $1,174.90 Median $5,623.41 Typical High $18,620.87 | Facility | None | $1,174.90 | $5,623.41 | $18,620.87 |
United Setting Professional Modifier None Typical Low $616.60 Median $4,168.69 Typical High $11,220.18 | Professional | None | $616.60 | $4,168.69 | $11,220.18 |
6 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 $223.87 Median $363.08 Typical High $2,818.38 | Professional | 52 · Reduced service | $223.87 | $363.08 | $2,818.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $144.54 Typical High $1,122.02 | Professional | 53 · Discontinued | $89.13 | $144.54 | $1,122.02 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $537.03 Typical High $4,168.69 | Professional | 54 · Surgery only | $331.13 | $537.03 | $4,168.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $107.15 Typical High $831.76 | Professional | 55 · Aftercare only | $66.07 | $107.15 | $831.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $72.44 Typical High $562.34 | Professional | 56 · Pre-op care only | $44.67 | $72.44 | $562.34 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $602.56 Median $602.56 Typical High $602.56 | Professional | 59 · Distinct service | $602.56 | $602.56 | $602.56 |
Where Missouri sits
The same service costs 4.3 times more in Alabama than in Maine. 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 $20,420ME $4,758
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.