How much rates vary
Facilitymedian $1,380 · 10th to 90th $575 to $1,905Professionalmedian $389 · 10th to 90th $195 to $933
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 $389.05 Median $954.99 Typical High $1,905.46 | Facility | None | $389.05 | $954.99 | $1,905.46 |
Aetna Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $933.25 | Professional | None | $389.05 | $389.05 | $933.25 |
Ambetter Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $199.53 | Professional | None | $85.11 | $85.11 | $199.53 |
BCBS Alabama Setting Facility Modifier None Typical Low $1,380.38 Median $1,412.54 Typical High $1,412.54 | Facility | None | $1,380.38 | $1,412.54 | $1,412.54 |
BCBS Alabama Setting Professional Modifier None Typical Low $870.96 Median $870.96 Typical High $870.96 | Professional | None | $870.96 | $870.96 | $870.96 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $891.25 Typical High $1,096.48 | Facility | None | $489.78 | $891.25 | $1,096.48 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $467.74 Typical High $537.03 | Professional | None | $229.09 | $467.74 | $537.03 |
United Setting Facility Modifier None Typical Low $467.74 Median $1,000.00 Typical High $3,162.28 | Facility | None | $467.74 | $1,000.00 | $3,162.28 |
United Setting Professional Modifier None Typical Low $162.18 Median $316.23 Typical High $524.81 | Professional | None | $162.18 | $316.23 | $524.81 |
8 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 $194.98 Median $194.98 Typical High $467.74 | Professional | 52 · Reduced service | $194.98 | $194.98 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $77.62 Median $77.62 Typical High $190.55 | Professional | 53 · Discontinued | $77.62 | $77.62 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $295.12 Median $295.12 Typical High $707.95 | Professional | 54 · Surgery only | $295.12 | $295.12 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $58.88 Typical High $141.25 | Professional | 55 · Aftercare only | $58.88 | $58.88 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $38.90 Typical High $93.33 | Professional | 56 · Pre-op care only | $38.90 | $38.90 | $93.33 |
Ambetter Setting Professional Modifier 51 · Multiple procedures Typical Low $81.28 Median $81.28 Typical High $81.28 | Professional | 51 · Multiple procedures | $81.28 | $81.28 | $81.28 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $162.18 Median $162.18 Typical High $162.18 | Professional | 59 · Distinct service | $162.18 | $162.18 | $162.18 |
BCBS Alabama Setting Professional Modifier 32 · Mandated service Typical Low $323.59 Median $446.68 Typical High $660.69 | Professional | 32 · Mandated service | $323.59 | $446.68 | $660.69 |
Where Alabama sits
The same service costs 4.1 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 $4,142MT $1,002
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.