How much rates vary
Facilitymedian $1,479 · 10th to 90th $525 to $3,715Professionalmedian $282 · 10th to 90th $166 to $1,995
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 $1,174.90 Median $3,162.28 Typical High $6,309.57 | Facility | None | $1,174.90 | $3,162.28 | $6,309.57 |
Aetna Setting Professional Modifier None Typical Low $154.88 Median $177.83 Typical High $229.09 | Professional | None | $154.88 | $177.83 | $229.09 |
Ambetter Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $229.09 | Professional | None | $204.17 | $204.17 | $229.09 |
Anthem BCBS Setting Facility Modifier None Typical Low $537.03 Median $1,348.96 Typical High $2,630.27 | Facility | None | $537.03 | $1,348.96 | $2,630.27 |
Anthem BCBS Setting Professional Modifier None Typical Low $181.97 Median $281.84 Typical High $371.54 | Professional | None | $181.97 | $281.84 | $371.54 |
BCBS Kansas City Setting Professional Modifier None Typical Low $154.88 Median $169.82 Typical High $275.42 | Professional | None | $154.88 | $169.82 | $275.42 |
Cigna Setting Facility Modifier None Typical Low $575.44 Median $912.01 Typical High $2,630.27 | Facility | None | $575.44 | $912.01 | $2,630.27 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $186.21 Typical High $380.19 | Professional | None | $158.49 | $186.21 | $380.19 |
Medica Setting Facility Modifier None Typical Low $446.68 Median $1,584.89 Typical High $12,022.64 | Facility | None | $446.68 | $1,584.89 | $12,022.64 |
Medica Setting Professional Modifier None Typical Low $208.93 Median $1,995.26 Typical High $1,995.26 | Professional | None | $208.93 | $1,995.26 | $1,995.26 |
United Setting Facility Modifier None Typical Low $562.34 Median $1,548.82 Typical High $3,235.94 | Facility | None | $562.34 | $1,548.82 | $3,235.94 |
United Setting Professional Modifier None Typical Low $158.49 Median $331.13 Typical High $407.38 | Professional | None | $158.49 | $331.13 | $407.38 |
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 $77.62 Median $83.18 Typical High $95.50 | Professional | 52 · Reduced service | $77.62 | $83.18 | $95.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $33.11 Typical High $38.02 | Professional | 53 · Discontinued | $30.90 | $33.11 | $38.02 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $125.89 Typical High $141.25 | Professional | 54 · Surgery only | $117.49 | $125.89 | $141.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $25.12 Typical High $28.18 | Professional | 55 · Aftercare only | $23.44 | $25.12 | $28.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $16.60 Typical High $19.05 | Professional | 56 · Pre-op care only | $15.49 | $16.60 | $19.05 |
Where Missouri sits
The same service costs 7.7 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 $4,047MT $526
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.