How much rates vary
Facilitymedian $589 · 10th to 90th $355 to $3,548Professionalmedian $182 · 10th to 90th $105 to $437
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 $120.23 Median $3,548.13 Typical High $7,585.78 | Facility | None | $120.23 | $3,548.13 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $109.65 Median $281.84 Typical High $616.60 | Professional | None | $109.65 | $281.84 | $616.60 |
Ambetter Setting Professional Modifier None Typical Low $97.72 Median $186.21 Typical High $537.03 | Professional | None | $97.72 | $186.21 | $537.03 |
Anthem BCBS Setting Facility Modifier None Typical Low $363.08 Median $776.25 Typical High $3,630.78 | Facility | None | $363.08 | $776.25 | $3,630.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $95.50 Median $162.18 Typical High $257.04 | Professional | None | $95.50 | $162.18 | $257.04 |
CareSource Setting Professional Modifier None Typical Low $229.09 Median $295.12 Typical High $363.08 | Professional | None | $229.09 | $295.12 | $363.08 |
Cigna Setting Facility Modifier None Typical Low $389.05 Median $501.19 Typical High $912.01 | Facility | None | $389.05 | $501.19 | $912.01 |
Cigna Setting Professional Modifier None Typical Low $123.03 Median $281.84 Typical High $645.65 | Professional | None | $123.03 | $281.84 | $645.65 |
Kaiser Permanente Setting Professional Modifier None Typical Low $123.03 Median $309.03 Typical High $1,778.28 | Professional | None | $123.03 | $309.03 | $1,778.28 |
Oscar Health Setting Facility Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $4,265.80 | Facility | None | $1,479.11 | $1,479.11 | $4,265.80 |
Oscar Health Setting Professional Modifier None Typical Low $104.71 Median $257.04 Typical High $562.34 | Professional | None | $104.71 | $257.04 | $562.34 |
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 $257.04 Typical High $588.84 | Professional | None | $112.20 | $257.04 | $588.84 |
6 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 $109.65 Typical High $147.91 | Professional | 52 · Reduced service | $54.95 | $109.65 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $43.65 Typical High $58.88 | Professional | 53 · Discontinued | $21.88 | $43.65 | $58.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $162.18 Typical High $218.78 | Professional | 54 · Surgery only | $83.18 | $162.18 | $218.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $32.36 Typical High $43.65 | Professional | 55 · Aftercare only | $16.60 | $32.36 | $43.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $21.88 Typical High $29.51 | Professional | 56 · Pre-op care only | $10.96 | $21.88 | $29.51 |
Ambetter Setting Professional Modifier Q6 · Substitute physician, paid per time Typical Low $549.54 Median $549.54 Typical High $549.54 | Professional | Q6 · Substitute physician, paid per time | $549.54 | $549.54 | $549.54 |
Where Georgia sits
The same service costs 5.3 times more in New York than in Maine. 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 $2,695ME $510
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.