How much rates vary
Facilitymedian $1,230 · 10th to 90th $178 to $2,884Professionalmedian $162 · 10th to 90th $126 to $309
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 $144.54 Median $177.83 Typical High $851.14 | Facility | None | $144.54 | $177.83 | $851.14 |
Aetna Setting Professional Modifier None Typical Low $141.25 Median $162.18 Typical High $208.93 | Professional | None | $141.25 | $162.18 | $208.93 |
Anthem BCBS Setting Facility Modifier None Typical Low $602.56 Median $1,698.24 Typical High $2,884.03 | Facility | None | $602.56 | $1,698.24 | $2,884.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $120.23 Median $154.88 Typical High $363.08 | Professional | None | $120.23 | $154.88 | $363.08 |
CareSource Setting Facility Modifier None Typical Low $128.82 Median $208.93 Typical High $1,621.81 | Facility | None | $128.82 | $208.93 | $1,621.81 |
CareSource Setting Professional Modifier None Typical Low $144.54 Median $186.21 Typical High $218.78 | Professional | None | $144.54 | $186.21 | $218.78 |
Cigna Setting Facility Modifier None Typical Low $229.09 Median $1,122.02 Typical High $1,318.26 | Facility | None | $229.09 | $1,122.02 | $1,318.26 |
Cigna Setting Professional Modifier None Typical Low $134.90 Median $199.53 Typical High $1,905.46 | Professional | None | $134.90 | $199.53 | $1,905.46 |
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 $138.04 Median $199.53 Typical High $275.42 | Professional | None | $138.04 | $199.53 | $275.42 |
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 $72.44 Median $89.13 Typical High $177.83 | Facility | 52 · Reduced service | $72.44 | $89.13 | $177.83 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $29.51 Median $35.48 Typical High $70.79 | Facility | 53 · Discontinued | $29.51 | $35.48 | $70.79 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $109.65 Median $134.90 Typical High $263.03 | Facility | 54 · Surgery only | $109.65 | $134.90 | $263.03 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $21.88 Median $26.92 Typical High $53.70 | Facility | 55 · Aftercare only | $21.88 | $26.92 | $53.70 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $14.45 Median $17.78 Typical High $35.48 | Facility | 56 · Pre-op care only | $14.45 | $17.78 | $35.48 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $70.79 Median $81.28 Typical High $100.00 | Professional | 52 · Reduced service | $70.79 | $81.28 | $100.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $32.36 Typical High $39.81 | Professional | 53 · Discontinued | $28.18 | $32.36 | $39.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $107.15 Median $123.03 Typical High $151.36 | Professional | 54 · Surgery only | $107.15 | $123.03 | $151.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $24.55 Typical High $30.20 | Professional | 55 · Aftercare only | $21.38 | $24.55 | $30.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $16.22 Typical High $19.95 | Professional | 56 · Pre-op care only | $14.13 | $16.22 | $19.95 |
Where Kentucky sits
The same service costs 10.0 times more in Colorado 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
CO $4,594ND $460
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.