How much rates vary
Facilitymedian $871 · 10th to 90th $263 to $5,495Professionalmedian $214 · 10th to 90th $170 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 $239.88 Median $309.03 Typical High $5,248.07 | Facility | None | $239.88 | $309.03 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $239.88 Median $275.42 Typical High $354.81 | Professional | None | $239.88 | $275.42 | $354.81 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,454.71 Median $4,365.16 Typical High $9,120.11 | Facility | None | $2,454.71 | $4,365.16 | $9,120.11 |
Anthem BCBS Setting Professional Modifier None Typical Low $169.82 Median $199.53 Typical High $281.84 | Professional | None | $169.82 | $199.53 | $281.84 |
CareSource Setting Facility Modifier None Typical Low $223.87 Median $371.54 Typical High $1,071.52 | Facility | None | $223.87 | $371.54 | $1,071.52 |
CareSource Setting Professional Modifier None Typical Low $223.87 Median $288.40 Typical High $371.54 | Professional | None | $223.87 | $288.40 | $371.54 |
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 $234.42 Median $257.04 Typical High $1,047.13 | Professional | None | $234.42 | $257.04 | $1,047.13 |
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 $234.42 Median $338.84 Typical High $446.68 | Professional | None | $234.42 | $338.84 | $446.68 |
6 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 $120.23 Median $123.03 Typical High $151.36 | Professional | 52 · Reduced service | $120.23 | $123.03 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $48.98 Typical High $61.66 | Professional | 53 · Discontinued | $47.86 | $48.98 | $61.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $181.97 Median $186.21 Typical High $229.09 | Professional | 54 · Surgery only | $181.97 | $186.21 | $229.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $37.15 Typical High $45.71 | Professional | 55 · Aftercare only | $36.31 | $37.15 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $24.55 Typical High $30.90 | Professional | 56 · Pre-op care only | $23.99 | $24.55 | $30.90 |
Ambetter Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $251.19 Typical High $251.19 | Professional | 53 · Discontinued | $251.19 | $251.19 | $251.19 |
Where Kentucky sits
The same service costs 5.6 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 $4,320MT $769
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.