How much rates vary
Facilitymedian $741 · 10th to 90th $331 to $4,365Professionalmedian $209 · 10th to 90th $74 to $513
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 $79.43 Median $3,548.13 Typical High $7,585.78 | Facility | None | $79.43 | $3,548.13 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $74.13 Median $204.17 Typical High $691.83 | Professional | None | $74.13 | $204.17 | $691.83 |
Ambetter Setting Professional Modifier None Typical Low $131.83 Median $138.04 Typical High $138.04 | Professional | None | $131.83 | $138.04 | $138.04 |
Anthem BCBS Setting Facility Modifier None Typical Low $389.05 Median $831.76 Typical High $4,570.88 | Facility | None | $389.05 | $831.76 | $4,570.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $69.18 Median $194.98 Typical High $457.09 | Professional | None | $69.18 | $194.98 | $457.09 |
CareSource Setting Professional Modifier None Typical Low $69.18 Median $69.18 Typical High $69.18 | Professional | None | $69.18 | $69.18 | $69.18 |
Cigna Setting Facility Modifier None Typical Low $263.03 Median $346.74 Typical High $2,290.87 | Facility | None | $263.03 | $346.74 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $87.10 Median $213.80 Typical High $630.96 | Professional | None | $87.10 | $213.80 | $630.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $83.18 Median $257.04 Typical High $407.38 | Professional | None | $83.18 | $257.04 | $407.38 |
Oscar Health Setting Professional Modifier None Typical Low $75.86 Median $426.58 Typical High $426.58 | Professional | None | $75.86 | $426.58 | $426.58 |
United Setting Facility Modifier None Typical Low $501.19 Median $724.44 Typical High $3,548.13 | Facility | None | $501.19 | $724.44 | $3,548.13 |
United Setting Professional Modifier None Typical Low $77.62 Median $223.87 Typical High $676.08 | Professional | None | $77.62 | $223.87 | $676.08 |
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 $37.15 Median $100.00 Typical High $158.49 | Professional | 52 · Reduced service | $37.15 | $100.00 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.14 Median $39.81 Typical High $63.10 | Professional | 53 · Discontinued | $15.14 | $39.81 | $63.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $56.23 Median $147.91 Typical High $239.88 | Professional | 54 · Surgery only | $56.23 | $147.91 | $239.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $30.20 Typical High $47.86 | Professional | 55 · Aftercare only | $11.22 | $30.20 | $47.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $19.95 Typical High $31.62 | Professional | 56 · Pre-op care only | $7.41 | $19.95 | $31.62 |
Where Georgia sits
The same service costs 9.0 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 $4,579MT $507
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.