How much rates vary
Facilitymedian $1,660 · 10th to 90th $617 to $4,365Professionalmedian $324 · 10th to 90th $263 to $513
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 $331.13 Median $1,348.96 Typical High $5,623.41 | Facility | None | $331.13 | $1,348.96 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $251.19 Median $263.03 Typical High $398.11 | Professional | None | $251.19 | $263.03 | $398.11 |
Ambetter Setting Professional Modifier None Typical Low $199.53 Median $302.00 Typical High $338.84 | Professional | None | $199.53 | $302.00 | $338.84 |
BCBS Setting Facility Modifier None Typical Low $1,348.96 Median $1,995.26 Typical High $3,388.44 | Facility | None | $1,348.96 | $1,995.26 | $3,388.44 |
BCBS Setting Professional Modifier None Typical Low $275.42 Median $323.59 Typical High $407.38 | Professional | None | $275.42 | $323.59 | $407.38 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $1,621.81 Typical High $2,137.96 | Facility | None | $630.96 | $1,621.81 | $2,137.96 |
Cigna Setting Professional Modifier None Typical Low $275.42 Median $380.19 Typical High $457.09 | Professional | None | $275.42 | $380.19 | $457.09 |
Hally Health Setting Professional Modifier None Typical Low $275.42 Median $407.38 Typical High $1,778.28 | Professional | None | $275.42 | $407.38 | $1,778.28 |
Hally Health Setting Facility Modifier None Typical Low $100.00 Median $100.00 Typical High $100.00 | Facility | None | $100.00 | $100.00 | $100.00 |
Hally Health Setting Professional Modifier None Typical Low $309.03 Median $323.59 Typical High $354.81 | Professional | None | $309.03 | $323.59 | $354.81 |
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 $676.08 Median $1,513.56 Typical High $4,365.16 | Facility | None | $676.08 | $1,513.56 | $4,365.16 |
United Setting Professional Modifier None Typical Low $281.84 Median $467.74 Typical High $602.56 | Professional | None | $281.84 | $467.74 | $602.56 |
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 $125.89 Median $131.83 Typical High $131.83 | Professional | 52 · Reduced service | $125.89 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $52.48 Typical High $52.48 | Professional | 53 · Discontinued | $51.29 | $52.48 | $52.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $190.55 Median $199.53 Typical High $199.53 | Professional | 54 · Surgery only | $190.55 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $39.81 Typical High $39.81 | Professional | 55 · Aftercare only | $38.02 | $39.81 | $39.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $26.30 Typical High $26.30 | Professional | 56 · Pre-op care only | $25.70 | $26.30 | $26.30 |
Where Illinois sits
The same service costs 5.1 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 $4,182MT $815
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.