How much rates vary
Facilitymedian $2,042 · 10th to 90th $562 to $6,761Professionalmedian $550 · 10th to 90th $437 to $2,042
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 $524.81 Median $4,897.79 Typical High $8,511.38 | Facility | None | $524.81 | $4,897.79 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $436.52 Median $467.74 Typical High $645.65 | Professional | None | $436.52 | $467.74 | $645.65 |
Ambetter Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $562.34 | Professional | None | $380.19 | $380.19 | $562.34 |
Anthem BCBS Setting Facility Modifier None Typical Low $537.03 Median $1,348.96 Typical High $4,677.35 | Facility | None | $537.03 | $1,348.96 | $4,677.35 |
Anthem BCBS Setting Professional Modifier None Typical Low $446.68 Median $537.03 Typical High $776.25 | Professional | None | $446.68 | $537.03 | $776.25 |
BCBS Kansas City Setting Professional Modifier None Typical Low $426.58 Median $478.63 Typical High $676.08 | Professional | None | $426.58 | $478.63 | $676.08 |
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 $446.68 Median $537.03 Typical High $977.24 | Professional | None | $446.68 | $537.03 | $977.24 |
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 $575.44 Median $1,122.02 Typical High $3,548.13 | Professional | None | $575.44 | $1,122.02 | $3,548.13 |
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 $446.68 Median $676.08 Typical High $1,148.15 | Professional | None | $446.68 | $676.08 | $1,148.15 |
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 $218.78 Median $234.42 Typical High $263.03 | Professional | 52 · Reduced service | $218.78 | $234.42 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $87.10 Median $93.33 Typical High $107.15 | Professional | 53 · Discontinued | $87.10 | $93.33 | $107.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $346.74 Typical High $398.11 | Professional | 54 · Surgery only | $331.13 | $346.74 | $398.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $70.79 Typical High $79.43 | Professional | 55 · Aftercare only | $66.07 | $70.79 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $46.77 Typical High $53.70 | Professional | 56 · Pre-op care only | $43.65 | $46.77 | $53.70 |
Where Missouri sits
The same service costs 5.9 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 $8,723MT $1,483
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.