How much rates vary
Facilitymedian $3,162 · 10th to 90th $955 to $7,762Professionalmedian $525 · 10th to 90th $417 to $1,950
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 $501.19 Median $4,677.35 Typical High $8,511.38 | Facility | None | $501.19 | $4,677.35 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $416.87 Median $457.09 Typical High $645.65 | Professional | None | $416.87 | $457.09 | $645.65 |
Ambetter Setting Professional Modifier None Typical Low $309.03 Median $363.08 Typical High $537.03 | Professional | None | $309.03 | $363.08 | $537.03 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,412.54 Median $3,801.89 Typical High $7,079.46 | Facility | None | $1,412.54 | $3,801.89 | $7,079.46 |
Anthem BCBS Setting Professional Modifier None Typical Low $426.58 Median $512.86 Typical High $758.58 | Professional | None | $426.58 | $512.86 | $758.58 |
BCBS Kansas City Setting Professional Modifier None Typical Low $407.38 Median $446.68 Typical High $645.65 | Professional | None | $407.38 | $446.68 | $645.65 |
Cigna Setting Facility Modifier None Typical Low $1,584.89 Median $4,786.30 Typical High $9,549.93 | Facility | None | $1,584.89 | $4,786.30 | $9,549.93 |
Cigna Setting Professional Modifier None Typical Low $436.52 Median $512.86 Typical High $933.25 | Professional | None | $436.52 | $512.86 | $933.25 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $1,862.09 Typical High $17,782.79 | Facility | None | $54.95 | $1,862.09 | $17,782.79 |
Medica Setting Professional Modifier None Typical Low $549.54 Median $1,096.48 Typical High $3,388.44 | Professional | None | $549.54 | $1,096.48 | $3,388.44 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $2,818.38 Typical High $5,888.44 | Facility | None | $1,000.00 | $2,818.38 | $5,888.44 |
United Setting Professional Modifier None Typical Low $436.52 Median $660.69 Typical High $1,096.48 | Professional | None | $436.52 | $660.69 | $1,096.48 |
7 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 $208.93 Median $223.87 Typical High $257.04 | Professional | 52 · Reduced service | $208.93 | $223.87 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $89.13 Typical High $102.33 | Professional | 53 · Discontinued | $83.18 | $89.13 | $102.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $331.13 Typical High $380.19 | Professional | 54 · Surgery only | $316.23 | $331.13 | $380.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $67.61 Typical High $75.86 | Professional | 55 · Aftercare only | $63.10 | $67.61 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $44.67 Typical High $51.29 | Professional | 56 · Pre-op care only | $41.69 | $44.67 | $51.29 |
Ambetter Setting Professional Modifier 58 · Staged procedure Typical Low $616.60 Median $616.60 Typical High $616.60 | Professional | 58 · Staged procedure | $616.60 | $616.60 | $616.60 |
Ambetter Setting Professional Modifier XS · Separate structure Typical Low $616.60 Median $616.60 Typical High $616.60 | Professional | XS · Separate structure | $616.60 | $616.60 | $616.60 |
Where Missouri 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.