How much rates vary
Facilitymedian $1,175 · 10th to 90th $363 to $4,266Professionalmedian $182 · 10th to 90th $112 to $933
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 $125.89 Median $2,511.89 Typical High $6,309.57 | Facility | None | $125.89 | $2,511.89 | $6,309.57 |
Aetna Setting Professional Modifier None Typical Low $93.33 Median $141.25 Typical High $208.93 | Professional | None | $93.33 | $141.25 | $208.93 |
Ambetter Setting Professional Modifier None Typical Low $107.15 Median $154.88 Typical High $154.88 | Professional | None | $107.15 | $154.88 | $154.88 |
Anthem BCBS Setting Facility Modifier None Typical Low $446.68 Median $1,621.81 Typical High $3,890.45 | Facility | None | $446.68 | $1,621.81 | $3,890.45 |
Anthem BCBS Setting Professional Modifier None Typical Low $114.82 Median $151.36 Typical High $199.53 | Professional | None | $114.82 | $151.36 | $199.53 |
BCBS Kansas City Setting Professional Modifier None Typical Low $107.15 Median $169.82 Typical High $213.80 | Professional | None | $107.15 | $169.82 | $213.80 |
Cigna Setting Facility Modifier None Typical Low $380.19 Median $501.19 Typical High $1,659.59 | Facility | None | $380.19 | $501.19 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $93.33 Median $162.18 Typical High $257.04 | Professional | None | $93.33 | $162.18 | $257.04 |
Medica Setting Facility Modifier None Typical Low $234.42 Median $1,096.48 Typical High $12,022.64 | Facility | None | $234.42 | $1,096.48 | $12,022.64 |
Medica Setting Professional Modifier None Typical Low $199.53 Median $933.25 Typical High $1,258.93 | Professional | None | $199.53 | $933.25 | $1,258.93 |
United Setting Facility Modifier None Typical Low $398.11 Median $1,148.15 Typical High $2,238.72 | Facility | None | $398.11 | $1,148.15 | $2,238.72 |
United Setting Professional Modifier None Typical Low $120.23 Median $199.53 Typical High $316.23 | Professional | None | $120.23 | $199.53 | $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 $46.77 Median $70.79 Typical High $87.10 | Professional | 52 · Reduced service | $46.77 | $70.79 | $87.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.62 Median $28.18 Typical High $34.67 | Professional | 53 · Discontinued | $18.62 | $28.18 | $34.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $70.79 Median $104.71 Typical High $128.82 | Professional | 54 · Surgery only | $70.79 | $104.71 | $128.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.13 Median $20.89 Typical High $25.70 | Professional | 55 · Aftercare only | $14.13 | $20.89 | $25.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.33 Median $14.13 Typical High $17.38 | Professional | 56 · Pre-op care only | $9.33 | $14.13 | $17.38 |
Where Missouri 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.