How much rates vary
Facilitymedian $1,413 · 10th to 90th $229 to $3,981Professionalmedian $200 · 10th to 90th $151 to $309
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 $173.78 Median $218.78 Typical High $2,290.87 | Facility | None | $173.78 | $218.78 | $2,290.87 |
Aetna Setting Professional Modifier None Typical Low $173.78 Median $177.83 Typical High $218.78 | Professional | None | $173.78 | $177.83 | $218.78 |
Anthem BCBS Setting Facility Modifier None Typical Low $724.44 Median $1,995.26 Typical High $4,265.80 | Facility | None | $724.44 | $1,995.26 | $4,265.80 |
Anthem BCBS Setting Professional Modifier None Typical Low $151.36 Median $199.53 Typical High $309.03 | Professional | None | $151.36 | $199.53 | $309.03 |
CareSource Setting Facility Modifier None Typical Low $162.18 Median $263.03 Typical High $1,445.44 | Facility | None | $162.18 | $263.03 | $1,445.44 |
CareSource Setting Professional Modifier None Typical Low $147.91 Median $208.93 Typical High $263.03 | Professional | None | $147.91 | $208.93 | $263.03 |
Cigna Setting Facility Modifier None Typical Low $288.40 Median $1,023.29 Typical High $1,659.59 | Facility | None | $288.40 | $1,023.29 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $169.82 Median $218.78 Typical High $1,174.90 | Professional | None | $169.82 | $218.78 | $1,174.90 |
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 $457.09 Median $794.33 Typical High $2,454.71 | Facility | None | $457.09 | $794.33 | $2,454.71 |
United Setting Professional Modifier None Typical Low $169.82 Median $251.19 Typical High $316.23 | Professional | None | $169.82 | $251.19 | $316.23 |
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 $87.10 Median $89.13 Typical High $109.65 | Professional | 52 · Reduced service | $87.10 | $89.13 | $109.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $35.48 Typical High $44.67 | Professional | 53 · Discontinued | $34.67 | $35.48 | $44.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $131.83 Median $131.83 Typical High $165.96 | Professional | 54 · Surgery only | $131.83 | $131.83 | $165.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $26.92 Typical High $33.11 | Professional | 55 · Aftercare only | $26.30 | $26.92 | $33.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $17.78 Typical High $21.88 | Professional | 56 · Pre-op care only | $17.38 | $17.78 | $21.88 |
Where Kentucky sits
The same service costs 7.3 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 $4,136MT $564
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.