How much rates vary
Facilitymedian $1,514 · 10th to 90th $240 to $4,467Professionalmedian $229 · 10th to 90th $69 to $1,047
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 $257.04 Median $3,162.28 Typical High $6,309.57 | Facility | None | $257.04 | $3,162.28 | $6,309.57 |
Aetna Setting Professional Modifier None Typical Low $69.18 Median $204.17 Typical High $316.23 | Professional | None | $69.18 | $204.17 | $316.23 |
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 $151.36 Median $1,621.81 Typical High $3,890.45 | Facility | None | $151.36 | $1,621.81 | $3,890.45 |
Anthem BCBS Setting Professional Modifier None Typical Low $67.61 Median $112.20 Typical High $288.40 | Professional | None | $67.61 | $112.20 | $288.40 |
BCBS Kansas City Setting Professional Modifier None Typical Low $74.13 Median $275.42 Typical High $407.38 | Professional | None | $74.13 | $275.42 | $407.38 |
Cigna Setting Facility Modifier None Typical Low $257.04 Median $389.05 Typical High $2,691.53 | Facility | None | $257.04 | $389.05 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $74.13 Median $204.17 Typical High $398.11 | Professional | None | $74.13 | $204.17 | $398.11 |
Medica Setting Facility Modifier None Typical Low $245.47 Median $1,445.44 Typical High $11,481.54 | Facility | None | $245.47 | $1,445.44 | $11,481.54 |
Medica Setting Professional Modifier None Typical Low $302.00 Median $1,047.13 Typical High $2,041.74 | Professional | None | $302.00 | $1,047.13 | $2,041.74 |
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 $81.28 Median $213.80 Typical High $478.63 | Professional | None | $81.28 | $213.80 | $478.63 |
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 $34.67 Median $91.20 Typical High $151.36 | Professional | 52 · Reduced service | $34.67 | $91.20 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $36.31 Typical High $60.26 | Professional | 53 · Discontinued | $13.80 | $36.31 | $60.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $51.29 Median $138.04 Typical High $223.87 | Professional | 54 · Surgery only | $51.29 | $138.04 | $223.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $27.54 Typical High $44.67 | Professional | 55 · Aftercare only | $10.23 | $27.54 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $18.20 Typical High $30.20 | Professional | 56 · Pre-op care only | $6.92 | $18.20 | $30.20 |
Where Missouri 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.