How much rates vary
Facilitymedian $1,660 · 10th to 90th $269 to $4,365Professionalmedian $229 · 10th to 90th $158 to $479
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 $162.18 Median $407.38 Typical High $851.14 | Facility | None | $162.18 | $407.38 | $851.14 |
Aetna Setting Professional Modifier None Typical Low $162.18 Median $234.42 Typical High $512.86 | Professional | None | $162.18 | $234.42 | $512.86 |
Anthem BCBS Setting Facility Modifier None Typical Low $891.25 Median $2,454.71 Typical High $4,897.79 | Facility | None | $891.25 | $2,454.71 | $4,897.79 |
Anthem BCBS Setting Professional Modifier None Typical Low $144.54 Median $190.55 Typical High $338.84 | Professional | None | $144.54 | $190.55 | $338.84 |
CareSource Setting Facility Modifier None Typical Low $151.36 Median $251.19 Typical High $1,445.44 | Facility | None | $151.36 | $251.19 | $1,445.44 |
CareSource Setting Professional Modifier None Typical Low $138.04 Median $194.98 Typical High $251.19 | Professional | None | $138.04 | $194.98 | $251.19 |
Cigna Setting Facility Modifier None Typical Low $269.15 Median $1,023.29 Typical High $1,659.59 | Facility | None | $269.15 | $1,023.29 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $407.38 Typical High $2,398.83 | Professional | None | $158.49 | $407.38 | $2,398.83 |
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 $169.82 Median $245.47 Typical High $501.19 | Professional | None | $169.82 | $245.47 | $501.19 |
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 $81.28 Median $107.15 Typical High $257.04 | Facility | 52 · Reduced service | $81.28 | $107.15 | $257.04 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $32.36 Median $42.66 Typical High $102.33 | Facility | 53 · Discontinued | $32.36 | $42.66 | $102.33 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $123.03 Median $158.49 Typical High $389.05 | Facility | 54 · Surgery only | $123.03 | $158.49 | $389.05 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $24.55 Median $32.36 Typical High $77.62 | Facility | 55 · Aftercare only | $24.55 | $32.36 | $77.62 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $16.22 Median $21.38 Typical High $51.29 | Facility | 56 · Pre-op care only | $16.22 | $21.38 | $51.29 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $81.28 Median $117.49 Typical High $257.04 | Professional | 52 · Reduced service | $81.28 | $117.49 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $46.77 Typical High $102.33 | Professional | 53 · Discontinued | $32.36 | $46.77 | $102.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $123.03 Median $173.78 Typical High $389.05 | Professional | 54 · Surgery only | $123.03 | $173.78 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $34.67 Typical High $77.62 | Professional | 55 · Aftercare only | $24.55 | $34.67 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $23.44 Typical High $51.29 | Professional | 56 · Pre-op care only | $16.22 | $23.44 | $51.29 |
Where Kentucky sits
The same service costs 5.4 times more in Colorado than in West Virginia. 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 $4,173WV $767
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.