How much rates vary
Facilitymedian $1,318 · 10th to 90th $295 to $3,715Professionalmedian $240 · 10th to 90th $145 to $407
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 $151.36 Median $295.12 Typical High $851.14 | Facility | None | $151.36 | $295.12 | $851.14 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $30.20 Median $75.86 Typical High $186.21 | Facility | 53 · Discontinued | $30.20 | $75.86 | $186.21 |
Aetna Setting Professional Modifier None Typical Low $151.36 Median $295.12 Typical High $371.54 | Professional | None | $151.36 | $295.12 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $74.13 Typical High $186.21 | Professional | 53 · Discontinued | $30.20 | $74.13 | $186.21 |
Ambetter Setting Professional Modifier None Typical Low $131.83 Median $131.83 Typical High $302.00 | Professional | None | $131.83 | $131.83 | $302.00 |
Anthem BCBS Setting Facility Modifier None Typical Low $741.31 Median $2,137.96 Typical High $4,365.16 | Facility | None | $741.31 | $2,137.96 | $4,365.16 |
Anthem BCBS Setting Professional Modifier None Typical Low $138.04 Median $234.42 Typical High $407.38 | Professional | None | $138.04 | $234.42 | $407.38 |
Anthem BCBS Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $151.36 Typical High $229.09 | Professional | 53 · Discontinued | $66.07 | $151.36 | $229.09 |
CareSource Setting Facility Modifier None Typical Low $138.04 Median $229.09 Typical High $831.76 | Facility | None | $138.04 | $229.09 | $831.76 |
CareSource Setting Professional Modifier None Typical Low $128.82 Median $177.83 Typical High $234.42 | Professional | None | $128.82 | $177.83 | $234.42 |
Cigna Setting Facility Modifier None Typical Low $251.19 Median $588.84 Typical High $1,318.26 | Facility | None | $251.19 | $588.84 | $1,318.26 |
Cigna Setting Professional Modifier None Typical Low $147.91 Median $288.40 Typical High $2,238.72 | Professional | None | $147.91 | $288.40 | $2,238.72 |
Cigna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $48.98 Typical High $199.53 | Professional | 53 · Discontinued | $37.15 | $48.98 | $199.53 |
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 $478.63 Median $870.96 Typical High $2,754.23 | Facility | None | $478.63 | $870.96 | $2,754.23 |
United Setting Professional Modifier None Typical Low $173.78 Median $269.15 Typical High $457.09 | Professional | None | $173.78 | $269.15 | $457.09 |
United Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $41.69 Typical High $177.83 | Professional | 53 · Discontinued | $37.15 | $41.69 | $177.83 |
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 Facility Modifier 54 · Surgery only Typical Low $112.20 Median $218.78 Typical High $316.23 | Facility | 54 · Surgery only | $112.20 | $218.78 | $316.23 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $22.39 Median $43.65 Typical High $63.10 | Facility | 55 · Aftercare only | $22.39 | $43.65 | $63.10 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $15.14 Median $29.51 Typical High $41.69 | Facility | 56 · Pre-op care only | $15.14 | $29.51 | $41.69 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $75.86 Median $95.50 Typical High $186.21 | Professional | 52 · Reduced service | $75.86 | $95.50 | $186.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $112.20 Median $218.78 Typical High $275.42 | Professional | 54 · Surgery only | $112.20 | $218.78 | $275.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $43.65 Typical High $56.23 | Professional | 55 · Aftercare only | $22.39 | $43.65 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $28.84 Typical High $37.15 | Professional | 56 · Pre-op care only | $15.14 | $28.84 | $37.15 |
Ambetter Setting Professional Modifier 33 · Preventive service Typical Low $169.82 Median $169.82 Typical High $169.82 | Professional | 33 · Preventive service | $169.82 | $169.82 | $169.82 |
Where Kentucky sits
The same service costs 4.7 times more in Connecticut than in North Dakota. 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
CT $3,190ND $672
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.