How much rates vary
Facilitymedian $1,230 · 10th to 90th $372 to $4,169Professionalmedian $1,023 · 10th to 90th $120 to $4,571
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 $131.83 Median $3,090.30 Typical High $6,309.57 | Facility | None | $131.83 | $3,090.30 | $6,309.57 |
Aetna Setting Professional Modifier None Typical Low $107.15 Median $870.96 Typical High $1,380.38 | Professional | None | $107.15 | $870.96 | $1,380.38 |
Ambetter Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $346.74 | Professional | None | $120.23 | $120.23 | $346.74 |
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 $123.03 Median $524.81 Typical High $1,202.26 | Professional | None | $123.03 | $524.81 | $1,202.26 |
BCBS Kansas City Setting Professional Modifier None Typical Low $109.65 Median $1,122.02 Typical High $1,584.89 | Professional | None | $109.65 | $1,122.02 | $1,584.89 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $954.99 Typical High $5,248.07 | Facility | None | $660.69 | $954.99 | $5,248.07 |
Cigna Setting Professional Modifier None Typical Low $114.82 Median $346.74 Typical High $1,659.59 | Professional | None | $114.82 | $346.74 | $1,659.59 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $1,096.48 Typical High $2,691.53 | Facility | None | $54.95 | $1,096.48 | $2,691.53 |
Medica Setting Professional Modifier None Typical Low $1,288.25 Median $4,570.88 Typical High $9,120.11 | Professional | None | $1,288.25 | $4,570.88 | $9,120.11 |
United Setting Facility Modifier None Typical Low $398.11 Median $1,148.15 Typical High $2,398.83 | Facility | None | $398.11 | $1,148.15 | $2,398.83 |
United Setting Professional Modifier None Typical Low $138.04 Median $912.01 Typical High $2,187.76 | Professional | None | $138.04 | $912.01 | $2,187.76 |
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 $53.70 Median $371.54 Typical High $676.08 | Professional | 52 · Reduced service | $53.70 | $371.54 | $676.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $147.91 Typical High $269.15 | Professional | 53 · Discontinued | $21.88 | $147.91 | $269.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $81.28 Median $562.34 Typical High $1,023.29 | Professional | 54 · Surgery only | $81.28 | $562.34 | $1,023.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $112.20 Typical High $204.17 | Professional | 55 · Aftercare only | $16.22 | $112.20 | $204.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $74.13 Typical High $134.90 | Professional | 56 · Pre-op care only | $10.72 | $74.13 | $134.90 |
Where Missouri sits
The same service costs 5.5 times more in Hawaii than in Maryland. 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
HI $4,440MD $808
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.