How much rates vary
Facilitymedian $1,072 · 10th to 90th $178 to $2,818Professionalmedian $129 · 10th to 90th $93 to $195
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 $109.65 Typical High $3,801.89 | Facility | None | $93.33 | $109.65 | $3,801.89 |
Aetna Setting Professional Modifier None Typical Low $93.33 Median $100.00 Typical High $141.25 | Professional | None | $93.33 | $100.00 | $141.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $588.84 Median $1,698.24 Typical High $2,884.03 | Facility | None | $588.84 | $1,698.24 | $2,884.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $93.33 Median $128.82 Typical High $194.98 | Professional | None | $93.33 | $128.82 | $194.98 |
CareSource Setting Facility Modifier None Typical Low $100.00 Median $165.96 Typical High $630.96 | Facility | None | $100.00 | $165.96 | $630.96 |
CareSource Setting Professional Modifier None Typical Low $104.71 Median $144.54 Typical High $173.78 | Professional | None | $104.71 | $144.54 | $173.78 |
Cigna Setting Facility Modifier None Typical Low $181.97 Median $436.52 Typical High $1,318.26 | Facility | None | $181.97 | $436.52 | $1,318.26 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $169.82 Typical High $954.99 | Professional | None | $104.71 | $169.82 | $954.99 |
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 $323.59 Median $588.84 Typical High $1,621.81 | Facility | None | $323.59 | $588.84 | $1,621.81 |
United Setting Professional Modifier None Typical Low $114.82 Median $162.18 Typical High $204.17 | Professional | None | $114.82 | $162.18 | $204.17 |
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 $46.77 Median $48.98 Typical High $61.66 | Professional | 52 · Reduced service | $46.77 | $48.98 | $61.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.62 Median $19.95 Typical High $24.55 | Professional | 53 · Discontinued | $18.62 | $19.95 | $24.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $70.79 Median $74.13 Typical High $91.20 | Professional | 54 · Surgery only | $70.79 | $74.13 | $91.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.13 Median $14.79 Typical High $18.20 | Professional | 55 · Aftercare only | $14.13 | $14.79 | $18.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.33 Median $9.77 Typical High $12.30 | Professional | 56 · Pre-op care only | $9.33 | $9.77 | $12.30 |
Where Kentucky 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.