How much rates vary
Facilitymedian $1,148 · 10th to 90th $339 to $2,884Professionalmedian $251 · 10th to 90th $186 to $525
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 $218.78 Median $251.19 Typical High $3,801.89 | Facility | None | $218.78 | $251.19 | $3,801.89 |
Aetna Setting Professional Modifier None Typical Low $218.78 Median $229.09 Typical High $338.84 | Professional | None | $218.78 | $229.09 | $338.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $371.54 Median $1,698.24 Typical High $2,884.03 | Facility | None | $371.54 | $1,698.24 | $2,884.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $181.97 Median $218.78 Typical High $398.11 | Professional | None | $181.97 | $218.78 | $398.11 |
CareSource Setting Facility Modifier None Typical Low $234.42 Median $380.19 Typical High $1,202.26 | Facility | None | $234.42 | $380.19 | $1,202.26 |
CareSource Setting Professional Modifier None Typical Low $263.03 Median $323.59 Typical High $398.11 | Professional | None | $263.03 | $323.59 | $398.11 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $851.14 Typical High $1,318.26 | Facility | None | $398.11 | $851.14 | $1,318.26 |
Cigna Setting Professional Modifier None Typical Low $245.47 Median $389.05 Typical High $1,778.28 | Professional | None | $245.47 | $389.05 | $1,778.28 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $134.90 | Professional | None | $33.11 | $33.11 | $134.90 |
United Setting Facility Modifier None Typical Low $457.09 Median $794.33 Typical High $2,454.71 | Facility | None | $457.09 | $794.33 | $2,454.71 |
United Setting Professional Modifier None Typical Low $269.15 Median $380.19 Typical High $724.44 | Professional | None | $269.15 | $380.19 | $724.44 |
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 $107.15 Median $114.82 Typical High $154.88 | Professional | 52 · Reduced service | $107.15 | $114.82 | $154.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $45.71 Typical High $61.66 | Professional | 53 · Discontinued | $43.65 | $45.71 | $61.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $162.18 Median $169.82 Typical High $229.09 | Professional | 54 · Surgery only | $162.18 | $169.82 | $229.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $32.36 Median $34.67 Typical High $45.71 | Professional | 55 · Aftercare only | $32.36 | $34.67 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $22.91 Typical High $30.90 | Professional | 56 · Pre-op care only | $21.88 | $22.91 | $30.90 |
Where Kentucky sits
The same service costs 6.0 times more in Colorado 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
CO $4,737MT $787
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.