How much rates vary
Facilitymedian $1,445 · 10th to 90th $288 to $4,365Professionalmedian $263 · 10th to 90th $182 to $550
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 $186.21 Median $446.68 Typical High $891.25 | Facility | None | $186.21 | $446.68 | $891.25 |
Aetna Setting Professional Modifier None Typical Low $186.21 Median $338.84 Typical High $562.34 | Professional | None | $186.21 | $338.84 | $562.34 |
Ambetter Setting Professional Modifier None Typical Low $208.93 Median $208.93 Typical High $208.93 | Professional | None | $208.93 | $208.93 | $208.93 |
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 $165.96 Median $223.87 Typical High $380.19 | Professional | None | $165.96 | $223.87 | $380.19 |
CareSource Setting Facility Modifier None Typical Low $173.78 Median $251.19 Typical High $1,445.44 | Facility | None | $173.78 | $251.19 | $1,445.44 |
CareSource Setting Professional Modifier None Typical Low $426.58 Median $457.09 Typical High $588.84 | Professional | None | $426.58 | $457.09 | $588.84 |
Cigna Setting Facility Modifier None Typical Low $309.03 Median $1,023.29 Typical High $1,659.59 | Facility | None | $309.03 | $1,023.29 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $181.97 Median $446.68 Typical High $2,630.27 | Professional | None | $181.97 | $446.68 | $2,630.27 |
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 $194.98 Median $281.84 Typical High $549.54 | Professional | None | $194.98 | $281.84 | $549.54 |
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 $93.33 Median $123.03 Typical High $281.84 | Facility | 52 · Reduced service | $93.33 | $123.03 | $281.84 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $37.15 Median $48.98 Typical High $112.20 | Facility | 53 · Discontinued | $37.15 | $48.98 | $112.20 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $141.25 Median $181.97 Typical High $426.58 | Facility | 54 · Surgery only | $141.25 | $181.97 | $426.58 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $28.18 Median $36.31 Typical High $85.11 | Facility | 55 · Aftercare only | $28.18 | $36.31 | $85.11 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $18.62 Median $24.55 Typical High $56.23 | Facility | 56 · Pre-op care only | $18.62 | $24.55 | $56.23 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $93.33 Median $134.90 Typical High $281.84 | Professional | 52 · Reduced service | $93.33 | $134.90 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $53.70 Typical High $112.20 | Professional | 53 · Discontinued | $37.15 | $53.70 | $112.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $199.53 Typical High $426.58 | Professional | 54 · Surgery only | $141.25 | $199.53 | $426.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $40.74 Typical High $85.11 | Professional | 55 · Aftercare only | $28.18 | $40.74 | $85.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $26.92 Typical High $56.23 | Professional | 56 · Pre-op care only | $18.62 | $26.92 | $56.23 |
Where Kentucky 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.