How much rates vary
Facilitymedian $1,445 · 10th to 90th $501 to $4,467Professionalmedian $295 · 10th to 90th $135 to $1,445
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 $478.63 Median $2,951.21 Typical High $6,309.57 | Facility | None | $478.63 | $2,951.21 | $6,309.57 |
Aetna Setting Professional Modifier None Typical Low $120.23 Median $288.40 Typical High $416.87 | Professional | None | $120.23 | $288.40 | $416.87 |
Anthem BCBS Setting Facility Modifier None Typical Low $524.81 Median $1,348.96 Typical High $2,630.27 | Facility | None | $524.81 | $1,348.96 | $2,630.27 |
Anthem BCBS Setting Professional Modifier None Typical Low $144.54 Median $281.84 Typical High $426.58 | Professional | None | $144.54 | $281.84 | $426.58 |
BCBS Kansas City Setting Professional Modifier None Typical Low $123.03 Median $389.05 Typical High $549.54 | Professional | None | $123.03 | $389.05 | $549.54 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $1,230.27 Typical High $2,630.27 | Facility | None | $524.81 | $1,230.27 | $2,630.27 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $302.00 Typical High $549.54 | Professional | None | $125.89 | $302.00 | $549.54 |
Medica Setting Facility Modifier None Typical Low $380.19 Median $1,445.44 Typical High $12,022.64 | Facility | None | $380.19 | $1,445.44 | $12,022.64 |
Medica Setting Professional Modifier None Typical Low $218.78 Median $1,445.44 Typical High $2,818.38 | Professional | None | $218.78 | $1,445.44 | $2,818.38 |
United Setting Facility Modifier None Typical Low $562.34 Median $1,548.82 Typical High $3,235.94 | Facility | None | $562.34 | $1,548.82 | $3,235.94 |
United Setting Professional Modifier None Typical Low $134.90 Median $234.42 Typical High $691.83 | Professional | None | $134.90 | $234.42 | $691.83 |
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 $58.88 Median $125.89 Typical High $208.93 | Professional | 52 · Reduced service | $58.88 | $125.89 | $208.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $51.29 Typical High $83.18 | Professional | 53 · Discontinued | $23.99 | $51.29 | $83.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $89.13 Median $190.55 Typical High $309.03 | Professional | 54 · Surgery only | $89.13 | $190.55 | $309.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $38.02 Typical High $61.66 | Professional | 55 · Aftercare only | $17.78 | $38.02 | $61.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $25.70 Typical High $41.69 | Professional | 56 · Pre-op care only | $12.02 | $25.70 | $41.69 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $109.65 Median $109.65 Typical High $109.65 | Professional | 59 · Distinct service | $109.65 | $109.65 | $109.65 |
Where Missouri 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.