How much rates vary
Facilitymedian $2,291 · 10th to 90th $417 to $5,129Professionalmedian $170 · 10th to 90th $115 to $282
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 $141.25 Median $2,570.40 Typical High $7,762.47 | Facility | None | $141.25 | $2,570.40 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $109.65 Median $165.96 Typical High $199.53 | Professional | None | $109.65 | $165.96 | $199.53 |
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 $128.82 Median $181.97 Typical High $269.15 | Professional | None | $128.82 | $181.97 | $269.15 |
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 $120.23 Median $177.83 Typical High $281.84 | Professional | None | $120.23 | $177.83 | $281.84 |
Denver HMP Setting Facility Modifier None Typical Low $109.65 Median $165.96 Typical High $257.04 | Facility | None | $109.65 | $165.96 | $257.04 |
Kaiser Permanente Setting Professional Modifier None Typical Low $123.03 Median $194.98 Typical High $295.12 | Professional | None | $123.03 | $194.98 | $295.12 |
Select Health Setting Facility Modifier None Typical Low $177.83 Median $331.13 Typical High $645.65 | Facility | None | $177.83 | $331.13 | $645.65 |
Select Health Setting Professional Modifier None Typical Low $109.65 Median $134.90 Typical High $177.83 | Professional | None | $109.65 | $134.90 | $177.83 |
United Setting Facility Modifier None Typical Low $489.78 Median $1,122.02 Typical High $2,884.03 | Facility | None | $489.78 | $1,122.02 | $2,884.03 |
United Setting Professional Modifier None Typical Low $123.03 Median $186.21 Typical High $316.23 | Professional | None | $123.03 | $186.21 | $316.23 |
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 $75.86 Typical High $83.18 | Professional | 52 · Reduced service | $54.95 | $75.86 | $83.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $30.90 Typical High $33.11 | Professional | 53 · Discontinued | $21.88 | $30.90 | $33.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $114.82 Typical High $123.03 | Professional | 54 · Surgery only | $83.18 | $114.82 | $123.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $22.91 Typical High $24.55 | Professional | 55 · Aftercare only | $16.60 | $22.91 | $24.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $15.14 Typical High $16.60 | Professional | 56 · Pre-op care only | $10.96 | $15.14 | $16.60 |
Where Colorado sits
The same service costs 6.3 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 $2,712MT $427
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.