How much rates vary
Facilitymedian $3,236 · 10th to 90th $851 to $6,166Professionalmedian $407 · 10th to 90th $339 to $575
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 $338.84 Median $1,737.80 Typical High $5,888.44 | Facility | None | $338.84 | $1,737.80 | $5,888.44 |
Aetna Setting Professional Modifier None Typical Low $323.59 Median $338.84 Typical High $478.63 | Professional | None | $323.59 | $338.84 | $478.63 |
Ambetter Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $398.11 | Professional | None | $398.11 | $398.11 | $398.11 |
BCBS Setting Facility Modifier None Typical Low $2,951.21 Median $3,981.07 Typical High $6,165.95 | Facility | None | $2,951.21 | $3,981.07 | $6,165.95 |
BCBS Setting Professional Modifier None Typical Low $354.81 Median $416.87 Typical High $512.86 | Professional | None | $354.81 | $416.87 | $512.86 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $3,630.78 Typical High $4,570.88 | Facility | None | $630.96 | $3,630.78 | $4,570.88 |
Cigna Setting Professional Modifier None Typical Low $354.81 Median $426.58 Typical High $549.54 | Professional | None | $354.81 | $426.58 | $549.54 |
Hally Health Setting Professional Modifier None Typical Low $346.74 Median $501.19 Typical High $1,737.80 | Professional | None | $346.74 | $501.19 | $1,737.80 |
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 $389.05 Median $416.87 Typical High $457.09 | Professional | None | $389.05 | $416.87 | $457.09 |
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 $1,047.13 Median $2,454.71 Typical High $7,079.46 | Facility | None | $1,047.13 | $2,454.71 | $7,079.46 |
United Setting Professional Modifier None Typical Low $354.81 Median $416.87 Typical High $676.08 | Professional | None | $354.81 | $416.87 | $676.08 |
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 $162.18 Median $169.82 Typical High $169.82 | Professional | 52 · Reduced service | $162.18 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $67.61 Typical High $67.61 | Professional | 53 · Discontinued | $66.07 | $67.61 | $67.61 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $251.19 Typical High $251.19 | Professional | 54 · Surgery only | $245.47 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $51.29 Typical High $51.29 | Professional | 55 · Aftercare only | $48.98 | $51.29 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $33.88 Typical High $33.88 | Professional | 56 · Pre-op care only | $32.36 | $33.88 | $33.88 |
Where Illinois sits
The same service costs 5.7 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 $5,952MT $1,050
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.