How much rates vary
Facilitymedian $1,349 · 10th to 90th $468 to $3,631Professionalmedian $288 · 10th to 90th $240 to $1,096
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 $1,548.82 Median $3,981.07 Typical High $7,762.47 | Facility | None | $1,548.82 | $3,981.07 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $229.09 Median $257.04 Typical High $354.81 | Professional | None | $229.09 | $257.04 | $354.81 |
Anthem BCBS Setting Facility Modifier None Typical Low $512.86 Median $1,230.27 Typical High $2,511.89 | Facility | None | $512.86 | $1,230.27 | $2,511.89 |
Anthem BCBS Setting Professional Modifier None Typical Low $245.47 Median $288.40 Typical High $416.87 | Professional | None | $245.47 | $288.40 | $416.87 |
BCBS Kansas City Setting Professional Modifier None Typical Low $223.87 Median $245.47 Typical High $354.81 | Professional | None | $223.87 | $245.47 | $354.81 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $851.14 Typical High $3,311.31 | Facility | None | $588.84 | $851.14 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $234.42 Median $245.47 Typical High $416.87 | Professional | None | $234.42 | $245.47 | $416.87 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $1,174.90 Typical High $3,630.78 | Facility | None | $54.95 | $1,174.90 | $3,630.78 |
Medica Setting Professional Modifier None Typical Low $302.00 Median $602.56 Typical High $1,862.09 | Professional | None | $302.00 | $602.56 | $1,862.09 |
United Setting Facility Modifier None Typical Low $562.34 Median $1,513.56 Typical High $3,235.94 | Facility | None | $562.34 | $1,513.56 | $3,235.94 |
United Setting Professional Modifier None Typical Low $239.88 Median $354.81 Typical High $602.56 | Professional | None | $239.88 | $354.81 | $602.56 |
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 $114.82 Median $125.89 Typical High $138.04 | Professional | 52 · Reduced service | $114.82 | $125.89 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $50.12 Typical High $56.23 | Professional | 53 · Discontinued | $45.71 | $50.12 | $56.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $173.78 Median $181.97 Typical High $208.93 | Professional | 54 · Surgery only | $173.78 | $181.97 | $208.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $37.15 Typical High $41.69 | Professional | 55 · Aftercare only | $34.67 | $37.15 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $25.12 Typical High $27.54 | Professional | 56 · Pre-op care only | $22.91 | $25.12 | $27.54 |
Ambetter Setting Professional Modifier 52 · Reduced service Typical Low $31.62 Median $31.62 Typical High $31.62 | Professional | 52 · Reduced service | $31.62 | $31.62 | $31.62 |
Where Missouri 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.