How much rates vary
Facilitymedian $1,259 · 10th to 90th $98 to $3,890Professionalmedian $123 · 10th to 90th $60 to $676
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 $67.61 Median $416.87 Typical High $1,000.00 | Facility | None | $67.61 | $416.87 | $1,000.00 |
Aetna Setting Professional Modifier None Typical Low $67.61 Median $131.83 Typical High $630.96 | Professional | None | $67.61 | $131.83 | $630.96 |
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 $60.26 Median $123.03 Typical High $446.68 | Professional | None | $60.26 | $123.03 | $446.68 |
CareSource Setting Facility Modifier None Typical Low $63.10 Median $104.71 Typical High $1,445.44 | Facility | None | $63.10 | $104.71 | $1,445.44 |
CareSource Setting Professional Modifier None Typical Low $57.54 Median $81.28 Typical High $104.71 | Professional | None | $57.54 | $81.28 | $104.71 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $794.33 Typical High $1,071.52 | Facility | None | $34.67 | $794.33 | $1,071.52 |
Cigna Setting Professional Modifier None Typical Low $66.07 Median $512.86 Typical High $2,630.27 | Professional | None | $66.07 | $512.86 | $2,630.27 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
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 $81.28 Median $199.53 Typical High $794.33 | Professional | None | $81.28 | $199.53 | $794.33 |
9 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 $33.88 Median $48.98 Typical High $316.23 | Facility | 52 · Reduced service | $33.88 | $48.98 | $316.23 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $13.49 Median $19.50 Typical High $128.82 | Facility | 53 · Discontinued | $13.49 | $19.50 | $128.82 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $51.29 Median $74.13 Typical High $478.63 | Facility | 54 · Surgery only | $51.29 | $74.13 | $478.63 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $10.23 Median $14.79 Typical High $95.50 | Facility | 55 · Aftercare only | $10.23 | $14.79 | $95.50 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $33.88 Median $48.98 Typical High $316.23 | Professional | 52 · Reduced service | $33.88 | $48.98 | $316.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.49 Median $19.50 Typical High $128.82 | Professional | 53 · Discontinued | $13.49 | $19.50 | $128.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $51.29 Median $74.13 Typical High $478.63 | Professional | 54 · Surgery only | $51.29 | $74.13 | $478.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $14.79 Typical High $95.50 | Professional | 55 · Aftercare only | $10.23 | $14.79 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $9.77 Typical High $63.10 | Professional | 56 · Pre-op care only | $6.76 | $9.77 | $63.10 |
Where Kentucky 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.