How much rates vary
Facilitymedian $1,413 · 10th to 90th $302 to $3,981Professionalmedian $269 · 10th to 90th $182 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 $190.55 Median $239.88 Typical High $5,248.07 | Facility | None | $190.55 | $239.88 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $190.55 Median $208.93 Typical High $269.15 | Professional | None | $190.55 | $208.93 | $269.15 |
Anthem BCBS Setting Facility Modifier None Typical Low $724.44 Median $1,995.26 Typical High $4,265.80 | Facility | None | $724.44 | $1,995.26 | $4,265.80 |
Anthem BCBS Setting Professional Modifier None Typical Low $169.82 Median $269.15 Typical High $380.19 | Professional | None | $169.82 | $269.15 | $380.19 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $107.15 Median $169.82 Typical High $239.88 | Professional | 62 · Two surgeons | $107.15 | $169.82 | $239.88 |
CareSource Setting Facility Modifier None Typical Low $177.83 Median $288.40 Typical High $1,445.44 | Facility | None | $177.83 | $288.40 | $1,445.44 |
CareSource Setting Professional Modifier None Typical Low $165.96 Median $223.87 Typical High $288.40 | Professional | None | $165.96 | $223.87 | $288.40 |
Cigna Setting Facility Modifier None Typical Low $316.23 Median $1,023.29 Typical High $1,659.59 | Facility | None | $316.23 | $1,023.29 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $186.21 Median $295.12 Typical High $1,584.89 | Professional | None | $186.21 | $295.12 | $1,584.89 |
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 $186.21 Median $331.13 Typical High $407.38 | Professional | None | $186.21 | $331.13 | $407.38 |
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 $95.50 Median $100.00 Typical High $123.03 | Professional | 52 · Reduced service | $95.50 | $100.00 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $39.81 Typical High $48.98 | Professional | 53 · Discontinued | $38.02 | $39.81 | $48.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $151.36 Typical High $181.97 | Professional | 54 · Surgery only | $141.25 | $151.36 | $181.97 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $30.20 Typical High $37.15 | Professional | 55 · Aftercare only | $28.18 | $30.20 | $37.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $19.95 Typical High $24.55 | Professional | 56 · Pre-op care only | $19.05 | $19.95 | $24.55 |
Where Kentucky sits
The same service costs 6.8 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 $4,179MT $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.