How much rates vary
Facilitymedian $1,660 · 10th to 90th $692 to $6,607Professionalmedian $708 · 10th to 90th $437 to $1,259
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 $457.09 Median $5,370.32 Typical High $7,943.28 | Facility | None | $457.09 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $457.09 Median $537.03 Typical High $1,258.93 | Professional | None | $457.09 | $537.03 | $1,258.93 |
Ambetter Setting Professional Modifier None Typical Low $489.78 Median $758.58 Typical High $831.76 | Professional | None | $489.78 | $758.58 | $831.76 |
Anthem BCBS Setting Facility Modifier None Typical Low $691.83 Median $1,348.96 Typical High $7,244.36 | Facility | None | $691.83 | $1,348.96 | $7,244.36 |
Anthem BCBS Setting Professional Modifier None Typical Low $416.87 Median $691.83 Typical High $1,148.15 | Professional | None | $416.87 | $691.83 | $1,148.15 |
CareSource Setting Professional Modifier None Typical Low $416.87 Median $575.44 Typical High $691.83 | Professional | None | $416.87 | $575.44 | $691.83 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $4,265.80 Typical High $5,754.40 | Facility | None | $630.96 | $4,265.80 | $5,754.40 |
Cigna Setting Professional Modifier None Typical Low $537.03 Median $831.76 Typical High $1,348.96 | Professional | None | $537.03 | $831.76 | $1,348.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $467.74 Median $537.03 Typical High $2,137.96 | Professional | None | $467.74 | $537.03 | $2,137.96 |
Oscar Health Setting Professional Modifier None Typical Low $426.58 Median $724.44 Typical High $954.99 | Professional | None | $426.58 | $724.44 | $954.99 |
United Setting Facility Modifier None Typical Low $851.14 Median $1,479.11 Typical High $5,011.87 | Facility | None | $851.14 | $1,479.11 | $5,011.87 |
United Setting Professional Modifier None Typical Low $467.74 Median $758.58 Typical High $1,445.44 | Professional | None | $467.74 | $758.58 | $1,445.44 |
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 $229.09 Median $229.09 Typical High $275.42 | Professional | 52 · Reduced service | $229.09 | $229.09 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $91.20 Typical High $109.65 | Professional | 53 · Discontinued | $91.20 | $91.20 | $109.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $346.74 Median $346.74 Typical High $407.38 | Professional | 54 · Surgery only | $346.74 | $346.74 | $407.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $69.18 Typical High $83.18 | Professional | 55 · Aftercare only | $69.18 | $69.18 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $45.71 Typical High $54.95 | Professional | 56 · Pre-op care only | $45.71 | $45.71 | $54.95 |
Ambetter Setting Professional Modifier 51 · Multiple procedures Typical Low $416.87 Median $416.87 Typical High $416.87 | Professional | 51 · Multiple procedures | $416.87 | $416.87 | $416.87 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $549.54 Median $776.25 Typical High $776.25 | Professional | 59 · Distinct service | $549.54 | $776.25 | $776.25 |
Ambetter Setting Professional Modifier XS · Separate structure Typical Low $794.33 Median $794.33 Typical High $794.33 | Professional | XS · Separate structure | $794.33 | $794.33 | $794.33 |
Where Georgia sits
The same service costs 6.1 times more in Alaska 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
AK $8,625MT $1,416
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.