How much rates vary
Facilitymedian $2,512 · 10th to 90th $468 to $7,762Professionalmedian $282 · 10th to 90th $204 to $1,778
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 $234.42 Median $4,897.79 Typical High $7,762.47 | Facility | None | $234.42 | $4,897.79 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $194.98 Median $213.80 Typical High $239.88 | Professional | None | $194.98 | $213.80 | $239.88 |
Ambetter Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $151.36 | Professional | None | $151.36 | $151.36 | $151.36 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,412.54 Median $3,715.35 Typical High $7,762.47 | Facility | None | $1,412.54 | $3,715.35 | $7,762.47 |
Anthem BCBS Setting Professional Modifier None Typical Low $213.80 Median $263.03 Typical High $363.08 | Professional | None | $213.80 | $263.03 | $363.08 |
BCBS Kansas City Setting Professional Modifier None Typical Low $190.55 Median $208.93 Typical High $302.00 | Professional | None | $190.55 | $208.93 | $302.00 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $691.83 Typical High $2,691.53 | Facility | None | $489.78 | $691.83 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $234.42 Typical High $446.68 | Professional | None | $199.53 | $234.42 | $446.68 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $1,174.90 Typical High $6,918.31 | Facility | None | $54.95 | $1,174.90 | $6,918.31 |
Medica Setting Professional Modifier None Typical Low $257.04 Median $1,778.28 Typical High $1,778.28 | Professional | None | $257.04 | $1,778.28 | $1,778.28 |
United Setting Facility Modifier None Typical Low $467.74 Median $2,290.87 Typical High $10,964.78 | Facility | None | $467.74 | $2,290.87 | $10,964.78 |
United Setting Professional Modifier None Typical Low $199.53 Median $309.03 Typical High $501.19 | Professional | None | $199.53 | $309.03 | $501.19 |
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 $97.72 Median $104.71 Typical High $117.49 | Professional | 52 · Reduced service | $97.72 | $104.71 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $41.69 Typical High $46.77 | Professional | 53 · Discontinued | $38.90 | $41.69 | $46.77 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $154.88 Typical High $177.83 | Professional | 54 · Surgery only | $144.54 | $154.88 | $177.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $30.90 Typical High $35.48 | Professional | 55 · Aftercare only | $28.84 | $30.90 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $20.89 Typical High $23.44 | Professional | 56 · Pre-op care only | $19.50 | $20.89 | $23.44 |
Where Missouri sits
The same service costs 13.4 times more in Maine 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
ME $8,787MT $655
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.