How much rates vary
Facilitymedian $933 · 10th to 90th $513 to $4,467Professionalmedian $229 · 10th to 90th $76 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 $74.13 Median $3,548.13 Typical High $7,585.78 | Facility | None | $74.13 | $3,548.13 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $69.18 Median $588.84 Typical High $707.95 | Professional | None | $69.18 | $588.84 | $707.95 |
Ambetter Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $117.49 | Professional | None | $117.49 | $117.49 | $117.49 |
Anthem BCBS Setting Facility Modifier None Typical Low $512.86 Median $1,000.00 Typical High $4,570.88 | Facility | None | $512.86 | $1,000.00 | $4,570.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $89.13 Median $208.93 Typical High $1,096.48 | Professional | None | $89.13 | $208.93 | $1,096.48 |
CareSource Setting Professional Modifier None Typical Low $64.57 Median $64.57 Typical High $64.57 | Professional | None | $64.57 | $64.57 | $64.57 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,071.52 Typical High $2,454.71 | Facility | None | $602.56 | $1,071.52 | $2,454.71 |
Cigna Setting Professional Modifier None Typical Low $83.18 Median $213.80 Typical High $1,288.25 | Professional | None | $83.18 | $213.80 | $1,288.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $70.79 Median $645.65 Typical High $831.76 | Professional | None | $70.79 | $645.65 | $831.76 |
Oscar Health Setting Professional Modifier None Typical Low $97.72 Median $109.65 Typical High $891.25 | Professional | None | $97.72 | $109.65 | $891.25 |
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 $74.13 Median $489.78 Typical High $1,318.26 | Professional | None | $74.13 | $489.78 | $1,318.26 |
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 $288.40 Typical High $331.13 | Professional | 52 · Reduced service | $34.67 | $288.40 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $117.49 Typical High $134.90 | Professional | 53 · Discontinued | $13.80 | $117.49 | $134.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $52.48 Median $436.52 Typical High $501.19 | Professional | 54 · Surgery only | $52.48 | $436.52 | $501.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $87.10 Typical High $100.00 | Professional | 55 · Aftercare only | $10.47 | $87.10 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $57.54 Typical High $67.61 | Professional | 56 · Pre-op care only | $6.92 | $57.54 | $67.61 |
Where Georgia sits
The same service costs 5.6 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 $4,728MT $843
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.