How much rates vary
Facilitymedian $1,549 · 10th to 90th $468 to $5,623Professionalmedian $708 · 10th to 90th $295 to $1,479
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 $354.81 Median $831.76 Typical High $1,548.82 | Facility | None | $354.81 | $831.76 | $1,548.82 |
Aetna Setting Professional Modifier None Typical Low $338.84 Median $794.33 Typical High $1,148.15 | Professional | None | $338.84 | $794.33 | $1,148.15 |
Anthem BCBS Setting Facility Modifier None Typical Low $741.31 Median $2,137.96 Typical High $10,000.00 | Facility | None | $741.31 | $2,137.96 | $10,000.00 |
Anthem BCBS Setting Professional Modifier None Typical Low $295.12 Median $707.95 Typical High $1,479.11 | Professional | None | $295.12 | $707.95 | $1,479.11 |
CareSource Setting Facility Modifier None Typical Low $309.03 Median $512.86 Typical High $2,818.38 | Facility | None | $309.03 | $512.86 | $2,818.38 |
CareSource Setting Professional Modifier None Typical Low $346.74 Median $446.68 Typical High $524.81 | Professional | None | $346.74 | $446.68 | $524.81 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $1,318.26 Typical High $2,041.74 | Facility | None | $549.54 | $1,318.26 | $2,041.74 |
Cigna Setting Professional Modifier None Typical Low $323.59 Median $794.33 Typical High $7,413.10 | Professional | None | $323.59 | $794.33 | $7,413.10 |
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 $707.95 Median $1,174.90 Typical High $3,890.45 | Facility | None | $707.95 | $1,174.90 | $3,890.45 |
United Setting Professional Modifier None Typical Low $354.81 Median $724.44 Typical High $1,479.11 | Professional | None | $354.81 | $724.44 | $1,479.11 |
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 $177.83 Median $416.87 Typical High $691.83 | Facility | 52 · Reduced service | $177.83 | $416.87 | $691.83 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $70.79 Median $165.96 Typical High $275.42 | Facility | 53 · Discontinued | $70.79 | $165.96 | $275.42 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $263.03 Median $616.60 Typical High $1,047.13 | Facility | 54 · Surgery only | $263.03 | $616.60 | $1,047.13 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $53.70 Median $125.89 Typical High $208.93 | Facility | 55 · Aftercare only | $53.70 | $125.89 | $208.93 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $35.48 Median $83.18 Typical High $138.04 | Facility | 56 · Pre-op care only | $35.48 | $83.18 | $138.04 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $169.82 Median $398.11 Typical High $524.81 | Professional | 52 · Reduced service | $169.82 | $398.11 | $524.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $158.49 Typical High $208.93 | Professional | 53 · Discontinued | $69.18 | $158.49 | $208.93 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $588.84 Typical High $776.25 | Professional | 54 · Surgery only | $257.04 | $588.84 | $776.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $120.23 Typical High $154.88 | Professional | 55 · Aftercare only | $51.29 | $120.23 | $154.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $79.43 Typical High $104.71 | Professional | 56 · Pre-op care only | $33.88 | $79.43 | $104.71 |
Where Kentucky sits
The same service costs 3.7 times more in Wisconsin than in North Dakota. 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
WI $6,561ND $1,783
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.