How much rates vary
Facilitymedian $2,239 · 10th to 90th $245 to $5,129Professionalmedian $263 · 10th to 90th $158 to $457
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 $229.09 Median $3,235.94 Typical High $7,762.47 | Facility | None | $229.09 | $3,235.94 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $147.91 Median $234.42 Typical High $436.52 | Professional | None | $147.91 | $234.42 | $436.52 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,137.96 Median $3,311.31 Typical High $5,370.32 | Facility | None | $2,137.96 | $3,311.31 | $5,370.32 |
Anthem BCBS Setting Professional Modifier None Typical Low $165.96 Median $275.42 Typical High $478.63 | Professional | None | $165.96 | $275.42 | $478.63 |
Cigna Setting Facility Modifier None Typical Low $173.78 Median $302.00 Typical High $1,659.59 | Facility | None | $173.78 | $302.00 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $239.88 Typical High $380.19 | Professional | None | $158.49 | $239.88 | $380.19 |
Denver HMP Setting Facility Modifier None Typical Low $151.36 Median $257.04 Typical High $371.54 | Facility | None | $151.36 | $257.04 | $371.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $141.25 Median $263.03 Typical High $446.68 | Professional | None | $141.25 | $263.03 | $446.68 |
Select Health Setting Facility Modifier None Typical Low $213.80 Median $257.04 Typical High $549.54 | Facility | None | $213.80 | $257.04 | $549.54 |
Select Health Setting Professional Modifier None Typical Low $91.20 Median $251.19 Typical High $512.86 | Professional | None | $91.20 | $251.19 | $512.86 |
United Setting Facility Modifier None Typical Low $239.88 Median $616.60 Typical High $1,905.46 | Facility | None | $239.88 | $616.60 | $1,905.46 |
United Setting Professional Modifier None Typical Low $162.18 Median $263.03 Typical High $446.68 | Professional | None | $162.18 | $263.03 | $446.68 |
5 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 $75.86 Median $104.71 Typical High $128.82 | Professional | 52 · Reduced service | $75.86 | $104.71 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $41.69 Typical High $51.29 | Professional | 53 · Discontinued | $30.20 | $41.69 | $51.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $158.49 Typical High $190.55 | Professional | 54 · Surgery only | $114.82 | $158.49 | $190.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $31.62 Typical High $38.90 | Professional | 55 · Aftercare only | $22.91 | $31.62 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $20.89 Typical High $25.70 | Professional | 56 · Pre-op care only | $15.14 | $20.89 | $25.70 |
Where Colorado sits
The same service costs 8.8 times more in New York than in Alabama. 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
NY $2,761AL $314
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.