How much rates vary
Facilitymedian $1,349 · 10th to 90th $302 to $3,981Professionalmedian $537 · 10th to 90th $166 to $1,096
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 $186.21 Median $776.25 Typical High $1,202.26 | Facility | None | $186.21 | $776.25 | $1,202.26 |
Aetna Setting Professional Modifier None Typical Low $186.21 Median $645.65 Typical High $977.24 | Professional | None | $186.21 | $645.65 | $977.24 |
Ambetter Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $165.96 | Professional | None | $165.96 | $165.96 | $165.96 |
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 $165.96 Median $537.03 Typical High $776.25 | Professional | None | $165.96 | $537.03 | $776.25 |
CareSource Setting Facility Modifier None Typical Low $151.36 Median $181.97 Typical High $288.40 | Facility | None | $151.36 | $181.97 | $288.40 |
CareSource Setting Professional Modifier None Typical Low $162.18 Median $223.87 Typical High $288.40 | Professional | None | $162.18 | $223.87 | $288.40 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $776.25 Typical High $912.01 | Facility | None | $34.67 | $776.25 | $912.01 |
Cigna Setting Professional Modifier None Typical Low $181.97 Median $776.25 Typical High $4,073.80 | Professional | None | $181.97 | $776.25 | $4,073.80 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $134.90 | Professional | None | $33.11 | $33.11 | $134.90 |
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 $229.09 Median $676.08 Typical High $1,318.26 | Professional | None | $229.09 | $676.08 | $1,318.26 |
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 $93.33 Median $162.18 Typical High $602.56 | Facility | 52 · Reduced service | $93.33 | $162.18 | $602.56 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $37.15 Median $64.57 Typical High $239.88 | Facility | 53 · Discontinued | $37.15 | $64.57 | $239.88 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $141.25 Median $239.88 Typical High $912.01 | Facility | 54 · Surgery only | $141.25 | $239.88 | $912.01 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $28.18 Median $47.86 Typical High $181.97 | Facility | 55 · Aftercare only | $28.18 | $47.86 | $181.97 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $18.62 Median $32.36 Typical High $120.23 | Facility | 56 · Pre-op care only | $18.62 | $32.36 | $120.23 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $93.33 Median $316.23 Typical High $489.78 | Professional | 52 · Reduced service | $93.33 | $316.23 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $128.82 Typical High $194.98 | Professional | 53 · Discontinued | $37.15 | $128.82 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $478.63 Typical High $741.31 | Professional | 54 · Surgery only | $141.25 | $478.63 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $95.50 Typical High $147.91 | Professional | 55 · Aftercare only | $28.18 | $95.50 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $64.57 Typical High $97.72 | Professional | 56 · Pre-op care only | $18.62 | $64.57 | $97.72 |
Where Kentucky sits
The same service costs 5.2 times more in Colorado 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
CO $5,090MD $977
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.