How much rates vary
Facilitymedian $1,259 · 10th to 90th $525 to $5,012Professionalmedian $363 · 10th to 90th $214 to $692
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 $363.08 Median $4,466.84 Typical High $7,585.78 | Facility | None | $363.08 | $4,466.84 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $204.17 Median $363.08 Typical High $891.25 | Professional | None | $204.17 | $363.08 | $891.25 |
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 $239.88 Median $363.08 Typical High $630.96 | Professional | None | $239.88 | $363.08 | $630.96 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $1,148.15 Typical High $1,548.82 | Facility | None | $524.81 | $1,148.15 | $1,548.82 |
Cigna Setting Professional Modifier None Typical Low $234.42 Median $380.19 Typical High $794.33 | Professional | None | $234.42 | $380.19 | $794.33 |
Kaiser Permanente Setting Professional Modifier None Typical Low $208.93 Median $371.54 Typical High $524.81 | Professional | None | $208.93 | $371.54 | $524.81 |
United Setting Facility Modifier None Typical Low $851.14 Median $1,479.11 Typical High $5,011.87 | Facility | None | $851.14 | $1,479.11 | $5,011.87 |
United Setting Professional Modifier None Typical Low $208.93 Median $389.05 Typical High $794.33 | Professional | None | $208.93 | $389.05 | $794.33 |
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 $102.33 Median $173.78 Typical High $204.17 | Professional | 52 · Reduced service | $102.33 | $173.78 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $69.18 Typical High $81.28 | Professional | 53 · Discontinued | $40.74 | $69.18 | $81.28 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $154.88 Median $257.04 Typical High $302.00 | Professional | 54 · Surgery only | $154.88 | $257.04 | $302.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $51.29 Typical High $61.66 | Professional | 55 · Aftercare only | $30.90 | $51.29 | $61.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $34.67 Typical High $40.74 | Professional | 56 · Pre-op care only | $20.42 | $34.67 | $40.74 |
Ambetter Setting Professional Modifier 51 · Multiple procedures Typical Low $181.97 Median $181.97 Typical High $181.97 | Professional | 51 · Multiple procedures | $181.97 | $181.97 | $181.97 |
Where Georgia sits
The same service costs 7.9 times more in Oklahoma 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
OK $5,867MT $745
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.