How much rates vary
Facilitymedian $676 · 10th to 90th $389 to $3,802Professionalmedian $263 · 10th to 90th $112 to $603
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 $104.71 Median $3,630.78 Typical High $7,413.10 | Facility | None | $104.71 | $3,630.78 | $7,413.10 |
Aetna Setting Professional Modifier None Typical Low $104.71 Median $309.03 Typical High $794.33 | Professional | None | $104.71 | $309.03 | $794.33 |
Ambetter Setting Professional Modifier None Typical Low $93.33 Median $154.88 Typical High $338.84 | Professional | None | $93.33 | $154.88 | $338.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $380.19 Median $776.25 Typical High $3,630.78 | Facility | None | $380.19 | $776.25 | $3,630.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $134.90 Median $263.03 Typical High $588.84 | Professional | None | $134.90 | $263.03 | $588.84 |
CareSource Setting Professional Modifier None Typical Low $251.19 Median $346.74 Typical High $416.87 | Professional | None | $251.19 | $346.74 | $416.87 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $602.56 Typical High $831.76 | Facility | None | $457.09 | $602.56 | $831.76 |
Cigna Setting Professional Modifier None Typical Low $123.03 Median $302.00 Typical High $660.69 | Professional | None | $123.03 | $302.00 | $660.69 |
Kaiser Permanente Setting Professional Modifier None Typical Low $109.65 Median $331.13 Typical High $1,479.11 | Professional | None | $109.65 | $331.13 | $1,479.11 |
Oscar Health Setting Facility Modifier None Typical Low $263.03 Median $316.23 Typical High $2,511.89 | Facility | None | $263.03 | $316.23 | $2,511.89 |
Oscar Health Setting Professional Modifier None Typical Low $177.83 Median $446.68 Typical High $537.03 | Professional | None | $177.83 | $446.68 | $537.03 |
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 $112.20 Median $309.03 Typical High $691.83 | Professional | None | $112.20 | $309.03 | $691.83 |
8 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 $52.48 Median $117.49 Typical High $169.82 | Professional | 52 · Reduced service | $52.48 | $117.49 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $46.77 Typical High $67.61 | Professional | 53 · Discontinued | $20.89 | $46.77 | $67.61 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $79.43 Median $177.83 Typical High $257.04 | Professional | 54 · Surgery only | $79.43 | $177.83 | $257.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $35.48 Typical High $51.29 | Professional | 55 · Aftercare only | $15.85 | $35.48 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $23.44 Typical High $33.88 | Professional | 56 · Pre-op care only | $10.47 | $23.44 | $33.88 |
Ambetter Setting Professional Modifier 51 · Multiple procedures Typical Low $263.03 Median $263.03 Typical High $263.03 | Professional | 51 · Multiple procedures | $263.03 | $263.03 | $263.03 |
Ambetter Setting Professional Modifier 79 · Unrelated procedure after surgery Typical Low $181.97 Median $263.03 Typical High $524.81 | Professional | 79 · Unrelated procedure after surgery | $181.97 | $263.03 | $524.81 |
Ambetter Setting Professional Modifier Q6 · Substitute physician, paid per time Typical Low $102.33 Median $102.33 Typical High $102.33 | Professional | Q6 · Substitute physician, paid per time | $102.33 | $102.33 | $102.33 |
Where Georgia sits
The same service costs 4.5 times more in Connecticut than in West Virginia. 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
CT $2,973WV $666
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.