How much rates vary
Facilitymedian $1,585 · 10th to 90th $269 to $4,365Professionalmedian $372 · 10th to 90th $170 to $692
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 $416.87 Typical High $851.14 | Facility | None | $173.78 | $416.87 | $851.14 |
Aetna Setting Professional Modifier None Typical Low $173.78 Median $269.15 Typical High $630.96 | Professional | None | $173.78 | $269.15 | $630.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $891.25 Median $2,454.71 Typical High $4,570.88 | Facility | None | $891.25 | $2,454.71 | $4,570.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $181.97 Median $354.81 Typical High $588.84 | Professional | None | $181.97 | $354.81 | $588.84 |
CareSource Setting Facility Modifier None Typical Low $141.25 Median $269.15 Typical High $1,412.54 | Facility | None | $141.25 | $269.15 | $1,412.54 |
CareSource Setting Professional Modifier None Typical Low $147.91 Median $208.93 Typical High $269.15 | Professional | None | $147.91 | $208.93 | $269.15 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $691.83 Typical High $831.76 | Facility | None | $34.67 | $691.83 | $831.76 |
Cigna Setting Professional Modifier None Typical Low $169.82 Median $501.19 Typical High $2,951.21 | Professional | None | $169.82 | $501.19 | $2,951.21 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $120.23 | Professional | None | $33.11 | $33.11 | $120.23 |
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 $208.93 Median $426.58 Typical High $933.25 | Professional | None | $208.93 | $426.58 | $933.25 |
10 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 52 · Reduced service Typical Low $87.10 Median $134.90 Typical High $316.23 | Facility | 52 · Reduced service | $87.10 | $134.90 | $316.23 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $35.48 Median $53.70 Typical High $125.89 | Facility | 53 · Discontinued | $35.48 | $53.70 | $125.89 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $131.83 Median $199.53 Typical High $467.74 | Facility | 54 · Surgery only | $131.83 | $199.53 | $467.74 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $26.30 Median $40.74 Typical High $93.33 | Facility | 55 · Aftercare only | $26.30 | $40.74 | $93.33 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $17.38 Median $26.92 Typical High $63.10 | Facility | 56 · Pre-op care only | $17.38 | $26.92 | $63.10 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $87.10 Median $134.90 Typical High $316.23 | Professional | 52 · Reduced service | $87.10 | $134.90 | $316.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $53.70 Typical High $125.89 | Professional | 53 · Discontinued | $35.48 | $53.70 | $125.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $131.83 Median $199.53 Typical High $467.74 | Professional | 54 · Surgery only | $131.83 | $199.53 | $467.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $40.74 Typical High $93.33 | Professional | 55 · Aftercare only | $26.30 | $40.74 | $93.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $26.92 Typical High $63.10 | Professional | 56 · Pre-op care only | $17.38 | $26.92 | $63.10 |
Where Kentucky sits
The same service costs 4.8 times more in Colorado than in Maryland. 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 $4,327MD $911
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.