How much rates vary
Facilitymedian $1,445 · 10th to 90th $501 to $4,677Professionalmedian $447 · 10th to 90th $200 to $1,862
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 $213.80 Median $2,511.89 Typical High $5,888.44 | Facility | None | $213.80 | $2,511.89 | $5,888.44 |
Aetna Setting Professional Modifier None Typical Low $177.83 Median $416.87 Typical High $549.54 | Professional | None | $177.83 | $416.87 | $549.54 |
Ambetter Setting Professional Modifier None Typical Low $77.62 Median $229.09 Typical High $263.03 | Professional | None | $77.62 | $229.09 | $263.03 |
Anthem BCBS Setting Facility Modifier None Typical Low $537.03 Median $1,348.96 Typical High $2,630.27 | Facility | None | $537.03 | $1,348.96 | $2,630.27 |
Anthem BCBS Setting Professional Modifier None Typical Low $218.78 Median $446.68 Typical High $562.34 | Professional | None | $218.78 | $446.68 | $562.34 |
BCBS Kansas City Setting Professional Modifier None Typical Low $181.97 Median $512.86 Typical High $724.44 | Professional | None | $181.97 | $512.86 | $724.44 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $1,230.27 Typical High $2,630.27 | Facility | None | $707.95 | $1,230.27 | $2,630.27 |
Cigna Setting Professional Modifier None Typical Low $190.55 Median $407.38 Typical High $707.95 | Professional | None | $190.55 | $407.38 | $707.95 |
Medica Setting Facility Modifier None Typical Low $446.68 Median $1,445.44 Typical High $16,218.10 | Facility | None | $446.68 | $1,445.44 | $16,218.10 |
Medica Setting Professional Modifier None Typical Low $316.23 Median $1,862.09 Typical High $3,630.78 | Professional | None | $316.23 | $1,862.09 | $3,630.78 |
United Setting Facility Modifier None Typical Low $562.34 Median $1,548.82 Typical High $3,235.94 | Facility | None | $562.34 | $1,548.82 | $3,235.94 |
United Setting Professional Modifier None Typical Low $204.17 Median $354.81 Typical High $912.01 | Professional | None | $204.17 | $354.81 | $912.01 |
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 $89.13 Median $177.83 Typical High $263.03 | Professional | 52 · Reduced service | $89.13 | $177.83 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $70.79 Typical High $107.15 | Professional | 53 · Discontinued | $35.48 | $70.79 | $107.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $269.15 Typical High $398.11 | Professional | 54 · Surgery only | $134.90 | $269.15 | $398.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $53.70 Typical High $79.43 | Professional | 55 · Aftercare only | $26.92 | $53.70 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $35.48 Typical High $52.48 | Professional | 56 · Pre-op care only | $17.78 | $35.48 | $52.48 |
Where Missouri 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.