How much rates vary
Facilitymedian $1,175 · 10th to 90th $138 to $2,884Professionalmedian $138 · 10th to 90th $85 to $355
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 $93.33 Median $138.04 Typical High $416.87 | Facility | None | $93.33 | $138.04 | $416.87 |
Aetna Setting Professional Modifier None Typical Low $93.33 Median $138.04 Typical High $218.78 | Professional | None | $93.33 | $138.04 | $218.78 |
Ambetter Setting Professional Modifier None Typical Low $83.18 Median $87.10 Typical High $123.03 | Professional | None | $83.18 | $87.10 | $123.03 |
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 $85.11 Median $141.25 Typical High $416.87 | Professional | None | $85.11 | $141.25 | $416.87 |
CareSource Setting Facility Modifier None Typical Low $87.10 Median $125.89 Typical High $1,621.81 | Facility | None | $87.10 | $125.89 | $1,621.81 |
CareSource Setting Professional Modifier None Typical Low $112.20 Median $134.90 Typical High $190.55 | Professional | None | $112.20 | $134.90 | $190.55 |
Cigna Setting Facility Modifier None Typical Low $151.36 Median $1,122.02 Typical High $1,318.26 | Facility | None | $151.36 | $1,122.02 | $1,318.26 |
Cigna Setting Professional Modifier None Typical Low $91.20 Median $165.96 Typical High $1,778.28 | Professional | None | $91.20 | $165.96 | $1,778.28 |
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 $117.49 Median $173.78 Typical High $275.42 | Professional | None | $117.49 | $173.78 | $275.42 |
11 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 $46.77 Median $69.18 Typical High $169.82 | Facility | 52 · Reduced service | $46.77 | $69.18 | $169.82 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $18.62 Median $28.18 Typical High $67.61 | Facility | 53 · Discontinued | $18.62 | $28.18 | $67.61 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $69.18 Median $104.71 Typical High $251.19 | Facility | 54 · Surgery only | $69.18 | $104.71 | $251.19 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $13.80 Median $20.89 Typical High $50.12 | Facility | 55 · Aftercare only | $13.80 | $20.89 | $50.12 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $9.33 Median $13.80 Typical High $33.88 | Facility | 56 · Pre-op care only | $9.33 | $13.80 | $33.88 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $46.77 Median $67.61 Typical High $75.86 | Professional | 52 · Reduced service | $46.77 | $67.61 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.62 Median $27.54 Typical High $30.20 | Professional | 53 · Discontinued | $18.62 | $27.54 | $30.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $69.18 Median $102.33 Typical High $112.20 | Professional | 54 · Surgery only | $69.18 | $102.33 | $112.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $20.42 Typical High $22.39 | Professional | 55 · Aftercare only | $13.80 | $20.42 | $22.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.33 Median $13.80 Typical High $15.14 | Professional | 56 · Pre-op care only | $9.33 | $13.80 | $15.14 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $102.33 Median $102.33 Typical High $102.33 | Professional | GC · Resident with teaching physician | $102.33 | $102.33 | $102.33 |
Where Kentucky sits
The same service costs 12.7 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 $4,551ND $359
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.