How much rates vary
Facilitymedian $2,512 · 10th to 90th $525 to $5,370Professionalmedian $162 · 10th to 90th $110 to $257
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 $954.99 Median $3,388.44 Typical High $8,709.64 | Facility | None | $954.99 | $3,388.44 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $3,388.44 | Professional | None | $109.65 | $109.65 | $3,388.44 |
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 $123.03 Median $173.78 Typical High $257.04 | Professional | None | $123.03 | $173.78 | $257.04 |
Cigna Setting Facility Modifier None Typical Low $416.87 Median $602.56 Typical High $1,659.59 | Facility | None | $416.87 | $602.56 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $128.82 Median $154.88 Typical High $218.78 | Professional | None | $128.82 | $154.88 | $218.78 |
Denver HMP Setting Facility Modifier None Typical Low $109.65 Median $154.88 Typical High $263.03 | Facility | None | $109.65 | $154.88 | $263.03 |
Kaiser Permanente Setting Professional Modifier None Typical Low $104.71 Median $147.91 Typical High $218.78 | Professional | None | $104.71 | $147.91 | $218.78 |
Select Health Setting Facility Modifier None Typical Low $104.71 Median $208.93 Typical High $645.65 | Facility | None | $104.71 | $208.93 | $645.65 |
Select Health Setting Professional Modifier None Typical Low $72.44 Median $104.71 Typical High $204.17 | Professional | None | $72.44 | $104.71 | $204.17 |
United Setting Facility Modifier None Typical Low $489.78 Median $1,174.90 Typical High $2,951.21 | Facility | None | $489.78 | $1,174.90 | $2,951.21 |
United Setting Professional Modifier None Typical Low $125.89 Median $169.82 Typical High $245.47 | Professional | None | $125.89 | $169.82 | $245.47 |
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 $54.95 Median $54.95 Typical High $61.66 | Professional | 52 · Reduced service | $54.95 | $54.95 | $61.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $21.88 Typical High $24.55 | Professional | 53 · Discontinued | $21.88 | $21.88 | $24.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $81.28 Median $81.28 Typical High $93.33 | Professional | 54 · Surgery only | $81.28 | $81.28 | $93.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $16.22 Typical High $18.62 | Professional | 55 · Aftercare only | $16.22 | $16.22 | $18.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $10.96 Typical High $12.30 | Professional | 56 · Pre-op care only | $10.96 | $10.96 | $12.30 |
Where Colorado sits
The same service costs 8.1 times more in New York 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
NY $2,852MT $352
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.