How much rates vary
Facilitymedian $1,660 · 10th to 90th $398 to $4,266Professionalmedian $324 · 10th to 90th $219 to $631
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 $229.09 Median $398.11 Typical High $2,290.87 | Facility | None | $229.09 | $398.11 | $2,290.87 |
Aetna Setting Professional Modifier None Typical Low $229.09 Median $398.11 Typical High $512.86 | Professional | None | $229.09 | $398.11 | $512.86 |
Ambetter Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $263.03 | Professional | None | $263.03 | $263.03 | $263.03 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,000.00 Median $2,238.72 Typical High $4,466.84 | Facility | None | $1,000.00 | $2,238.72 | $4,466.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $204.17 Median $275.42 Typical High $630.96 | Professional | None | $204.17 | $275.42 | $630.96 |
CareSource Setting Facility Modifier None Typical Low $186.21 Median $346.74 Typical High $1,071.52 | Facility | None | $186.21 | $346.74 | $1,071.52 |
CareSource Setting Professional Modifier None Typical Low $199.53 Median $263.03 Typical High $346.74 | Professional | None | $199.53 | $263.03 | $346.74 |
Cigna Setting Facility Modifier None Typical Low $371.54 Median $758.58 Typical High $1,659.59 | Facility | None | $371.54 | $758.58 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $223.87 Median $398.11 Typical High $2,951.21 | Professional | None | $223.87 | $398.11 | $2,951.21 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $234.42 | Professional | None | $33.11 | $33.11 | $234.42 |
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 $275.42 Median $407.38 Typical High $676.08 | Professional | None | $275.42 | $407.38 | $676.08 |
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 $114.82 Median $199.53 Typical High $281.84 | Facility | 52 · Reduced service | $114.82 | $199.53 | $281.84 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $45.71 Median $81.28 Typical High $112.20 | Facility | 53 · Discontinued | $45.71 | $81.28 | $112.20 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $169.82 Median $302.00 Typical High $416.87 | Facility | 54 · Surgery only | $169.82 | $302.00 | $416.87 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $34.67 Median $60.26 Typical High $83.18 | Facility | 55 · Aftercare only | $34.67 | $60.26 | $83.18 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $22.91 Median $39.81 Typical High $56.23 | Facility | 56 · Pre-op care only | $22.91 | $39.81 | $56.23 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $114.82 Median $199.53 Typical High $257.04 | Professional | 52 · Reduced service | $114.82 | $199.53 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $79.43 Typical High $102.33 | Professional | 53 · Discontinued | $45.71 | $79.43 | $102.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $169.82 Median $295.12 Typical High $380.19 | Professional | 54 · Surgery only | $169.82 | $295.12 | $380.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $60.26 Typical High $75.86 | Professional | 55 · Aftercare only | $34.67 | $60.26 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $39.81 Typical High $51.29 | Professional | 56 · Pre-op care only | $22.91 | $39.81 | $51.29 |
Where Kentucky sits
The same service costs 4.3 times more in Colorado 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
CO $4,191ND $964
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.