How much rates vary
Facilitymedian $575 · 10th to 90th $363 to $3,548Professionalmedian $155 · 10th to 90th $110 to $295
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 $323.59 Median $3,548.13 Typical High $7,585.78 | Facility | None | $323.59 | $3,548.13 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $107.15 Median $117.49 Typical High $323.59 | Professional | None | $107.15 | $117.49 | $323.59 |
Ambetter Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $199.53 | Professional | None | $199.53 | $199.53 | $199.53 |
Anthem BCBS Setting Facility Modifier None Typical Low $380.19 Median $776.25 Typical High $3,630.78 | Facility | None | $380.19 | $776.25 | $3,630.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $109.65 Median $154.88 Typical High $288.40 | Professional | None | $109.65 | $154.88 | $288.40 |
Cigna Setting Facility Modifier None Typical Low $354.81 Median $467.74 Typical High $660.69 | Facility | None | $354.81 | $467.74 | $660.69 |
Cigna Setting Professional Modifier None Typical Low $123.03 Median $181.97 Typical High $380.19 | Professional | None | $123.03 | $181.97 | $380.19 |
Kaiser Permanente Setting Professional Modifier None Typical Low $109.65 Median $134.90 Typical High $407.38 | Professional | None | $109.65 | $134.90 | $407.38 |
United Setting Facility Modifier None Typical Low $331.13 Median $501.19 Typical High $2,454.71 | Facility | None | $331.13 | $501.19 | $2,454.71 |
United Setting Professional Modifier None Typical Low $112.20 Median $177.83 Typical High $338.84 | Professional | None | $112.20 | $177.83 | $338.84 |
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 $53.70 Median $53.70 Typical High $63.10 | Professional | 52 · Reduced service | $53.70 | $53.70 | $63.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $21.38 Typical High $25.12 | Professional | 53 · Discontinued | $21.38 | $21.38 | $25.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $81.28 Median $81.28 Typical High $95.50 | Professional | 54 · Surgery only | $81.28 | $81.28 | $95.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $16.22 Typical High $19.05 | Professional | 55 · Aftercare only | $16.22 | $16.22 | $19.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $10.72 Typical High $12.59 | Professional | 56 · Pre-op care only | $10.72 | $10.72 | $12.59 |
Where Georgia 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.