How much rates vary
Facilitymedian $1,445 · 10th to 90th $427 to $3,715Professionalmedian $123 · 10th to 90th $98 to $427
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 $97.72 Median $107.15 Typical High $128.82 | Professional | None | $97.72 | $107.15 | $128.82 |
Anthem BCBS Setting Facility Modifier None Typical Low $446.68 Median $1,621.81 Typical High $3,890.45 | Facility | None | $446.68 | $1,621.81 | $3,890.45 |
Anthem BCBS Setting Professional Modifier None Typical Low $91.20 Median $120.23 Typical High $177.83 | Professional | None | $91.20 | $120.23 | $177.83 |
BCBS Kansas City Setting Professional Modifier None Typical Low $97.72 Median $107.15 Typical High $154.88 | Professional | None | $97.72 | $107.15 | $154.88 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $660.69 Typical High $1,659.59 | Facility | None | $489.78 | $660.69 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $102.33 Median $117.49 Typical High $213.80 | Professional | None | $102.33 | $117.49 | $213.80 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $1,023.29 Typical High $2,884.03 | Facility | None | $54.95 | $1,023.29 | $2,884.03 |
Medica Setting Professional Modifier None Typical Low $125.89 Median $257.04 Typical High $776.25 | Professional | None | $125.89 | $257.04 | $776.25 |
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 $102.33 Median $147.91 Typical High $257.04 | Professional | None | $102.33 | $147.91 | $257.04 |
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 $48.98 Median $52.48 Typical High $60.26 | Professional | 52 · Reduced service | $48.98 | $52.48 | $60.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.50 Median $20.89 Typical High $23.99 | Professional | 53 · Discontinued | $19.50 | $20.89 | $23.99 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $74.13 Median $77.62 Typical High $89.13 | Professional | 54 · Surgery only | $74.13 | $77.62 | $89.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.79 Median $15.49 Typical High $17.78 | Professional | 55 · Aftercare only | $14.79 | $15.49 | $17.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.77 Median $10.47 Typical High $12.02 | Professional | 56 · Pre-op care only | $9.77 | $10.47 | $12.02 |
Ambetter Setting Professional Modifier 51 · Multiple procedures Typical Low $46.77 Median $46.77 Typical High $46.77 | Professional | 51 · Multiple procedures | $46.77 | $46.77 | $46.77 |
Where Missouri sits
The same service costs 8.8 times more in New York 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
NY $2,931MT $332
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.