How much rates vary
Facilitymedian $933 · 10th to 90th $513 to $5,012Professionalmedian $288 · 10th to 90th $200 to $501
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 $218.78 Median $6,309.57 Typical High $10,000.00 | Facility | None | $218.78 | $6,309.57 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $1,071.52 | Professional | None | $194.98 | $194.98 | $1,071.52 |
Anthem BCBS Setting Facility Modifier None Typical Low $512.86 Median $1,000.00 Typical High $4,570.88 | Facility | None | $512.86 | $1,000.00 | $4,570.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $208.93 Median $288.40 Typical High $489.78 | Professional | None | $208.93 | $288.40 | $489.78 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,023.29 Typical High $2,398.83 | Facility | None | $602.56 | $1,023.29 | $2,398.83 |
Cigna Setting Professional Modifier None Typical Low $239.88 Median $346.74 Typical High $630.96 | Professional | None | $239.88 | $346.74 | $630.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $177.83 Median $213.80 Typical High $1,380.38 | Professional | None | $177.83 | $213.80 | $1,380.38 |
United Setting Facility Modifier None Typical Low $501.19 Median $724.44 Typical High $3,548.13 | Facility | None | $501.19 | $724.44 | $3,548.13 |
United Setting Professional Modifier None Typical Low $213.80 Median $371.54 Typical High $575.44 | Professional | None | $213.80 | $371.54 | $575.44 |
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 $97.72 Median $97.72 Typical High $114.82 | Professional | 52 · Reduced service | $97.72 | $97.72 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $38.90 Typical High $45.71 | Professional | 53 · Discontinued | $38.90 | $38.90 | $45.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $144.54 Typical High $173.78 | Professional | 54 · Surgery only | $144.54 | $144.54 | $173.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $28.84 Typical High $34.67 | Professional | 55 · Aftercare only | $28.84 | $28.84 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $19.50 Typical High $22.91 | Professional | 56 · Pre-op care only | $19.50 | $19.50 | $22.91 |
Where Georgia sits
The same service costs 7.6 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 $4,681MT $618
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.