How much rates vary
Facilitymedian $1,122 · 10th to 90th $191 to $2,818Professionalmedian $170 · 10th to 90th $120 to $398
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 $125.89 Median $346.74 Typical High $851.14 | Facility | None | $125.89 | $346.74 | $851.14 |
Aetna Setting Professional Modifier None Typical Low $125.89 Median $177.83 Typical High $436.52 | Professional | None | $125.89 | $177.83 | $436.52 |
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 $109.65 Median $144.54 Typical High $269.15 | Professional | None | $109.65 | $144.54 | $269.15 |
CareSource Setting Facility Modifier None Typical Low $117.49 Median $190.55 Typical High $1,445.44 | Facility | None | $117.49 | $190.55 | $1,445.44 |
CareSource Setting Professional Modifier None Typical Low $109.65 Median $144.54 Typical High $190.55 | Professional | None | $109.65 | $144.54 | $190.55 |
Cigna Setting Facility Modifier None Typical Low $208.93 Median $1,000.00 Typical High $1,318.26 | Facility | None | $208.93 | $1,000.00 | $1,318.26 |
Cigna Setting Professional Modifier None Typical Low $123.03 Median $346.74 Typical High $1,995.26 | Professional | None | $123.03 | $346.74 | $1,995.26 |
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 $457.09 Median $794.33 Typical High $2,454.71 | Facility | None | $457.09 | $794.33 | $2,454.71 |
United Setting Professional Modifier None Typical Low $128.82 Median $181.97 Typical High $416.87 | Professional | None | $128.82 | $181.97 | $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 $63.10 Median $81.28 Typical High $218.78 | Facility | 52 · Reduced service | $63.10 | $81.28 | $218.78 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $25.12 Median $32.36 Typical High $89.13 | Facility | 53 · Discontinued | $25.12 | $32.36 | $89.13 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $95.50 Median $120.23 Typical High $331.13 | Facility | 54 · Surgery only | $95.50 | $120.23 | $331.13 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $19.05 Median $23.99 Typical High $66.07 | Facility | 55 · Aftercare only | $19.05 | $23.99 | $66.07 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $12.59 Median $16.22 Typical High $43.65 | Facility | 56 · Pre-op care only | $12.59 | $16.22 | $43.65 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $63.10 Median $89.13 Typical High $218.78 | Professional | 52 · Reduced service | $63.10 | $89.13 | $218.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $35.48 Typical High $89.13 | Professional | 53 · Discontinued | $25.12 | $35.48 | $89.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $95.50 Median $131.83 Typical High $331.13 | Professional | 54 · Surgery only | $95.50 | $131.83 | $331.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $26.92 Typical High $66.07 | Professional | 55 · Aftercare only | $19.05 | $26.92 | $66.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $17.78 Typical High $43.65 | Professional | 56 · Pre-op care only | $12.59 | $17.78 | $43.65 |
Where Kentucky sits
The same service costs 5.7 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 $4,090MT $722
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.