How much rates vary
Facilitymedian $1,318 · 10th to 90th $126 to $3,890Professionalmedian $95 · 10th to 90th $56 to $275
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 $72.44 Median $245.47 Typical High $851.14 | Facility | None | $72.44 | $245.47 | $851.14 |
Aetna Setting Professional Modifier None Typical Low $72.44 Median $177.83 Typical High $316.23 | Professional | None | $72.44 | $177.83 | $316.23 |
Ambetter Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $83.18 | Professional | None | $83.18 | $83.18 | $83.18 |
Anthem BCBS Setting Facility Modifier None Typical Low $724.44 Median $1,995.26 Typical High $4,265.80 | Facility | None | $724.44 | $1,995.26 | $4,265.80 |
Anthem BCBS Setting Professional Modifier None Typical Low $53.70 Median $87.10 Typical High $186.21 | Professional | None | $53.70 | $87.10 | $186.21 |
CareSource Setting Facility Modifier None Typical Low $58.88 Median $112.20 Typical High $371.54 | Facility | None | $58.88 | $112.20 | $371.54 |
CareSource Setting Professional Modifier None Typical Low $61.66 Median $87.10 Typical High $114.82 | Professional | None | $61.66 | $87.10 | $114.82 |
Cigna Setting Facility Modifier None Typical Low $125.89 Median $309.03 Typical High $1,318.26 | Facility | None | $125.89 | $309.03 | $1,318.26 |
Cigna Setting Professional Modifier None Typical Low $70.79 Median $229.09 Typical High $1,479.11 | Professional | None | $70.79 | $229.09 | $1,479.11 |
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 $457.09 Median $794.33 Typical High $2,454.71 | Facility | None | $457.09 | $794.33 | $2,454.71 |
United Setting Professional Modifier None Typical Low $72.44 Median $165.96 Typical High $295.12 | Professional | None | $72.44 | $165.96 | $295.12 |
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 $36.31 Median $46.77 Typical High $158.49 | Facility | 52 · Reduced service | $36.31 | $46.77 | $158.49 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $14.79 Median $18.62 Typical High $63.10 | Facility | 53 · Discontinued | $14.79 | $18.62 | $63.10 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $54.95 Median $69.18 Typical High $234.42 | Facility | 54 · Surgery only | $54.95 | $69.18 | $234.42 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $10.96 Median $13.80 Typical High $46.77 | Facility | 55 · Aftercare only | $10.96 | $13.80 | $46.77 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $7.24 Median $9.33 Typical High $31.62 | Facility | 56 · Pre-op care only | $7.24 | $9.33 | $31.62 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $36.31 Median $51.29 Typical High $158.49 | Professional | 52 · Reduced service | $36.31 | $51.29 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.79 Median $20.42 Typical High $63.10 | Professional | 53 · Discontinued | $14.79 | $20.42 | $63.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $54.95 Median $77.62 Typical High $234.42 | Professional | 54 · Surgery only | $54.95 | $77.62 | $234.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $15.49 Typical High $46.77 | Professional | 55 · Aftercare only | $10.96 | $15.49 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.24 Median $10.23 Typical High $31.62 | Professional | 56 · Pre-op care only | $7.24 | $10.23 | $31.62 |
Where Kentucky 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.