How much rates vary
Facilitymedian $1,318 · 10th to 90th $145 to $3,890Professionalmedian $117 · 10th to 90th $85 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 $104.71 Median $144.54 Typical High $851.14 | Facility | None | $104.71 | $144.54 | $851.14 |
Aetna Setting Professional Modifier None Typical Low $102.33 Median $138.04 Typical High $151.36 | Professional | None | $102.33 | $138.04 | $151.36 |
Anthem BCBS Setting Facility Modifier None Typical Low $724.44 Median $1,995.26 Typical High $4,265.80 | Facility | None | $724.44 | $1,995.26 | $4,265.80 |
Anthem BCBS Setting Professional Modifier None Typical Low $79.43 Median $95.50 Typical High $131.83 | Professional | None | $79.43 | $95.50 | $131.83 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $117.49 Median $144.54 Typical High $194.98 | Professional | 50 · Both sides | $117.49 | $144.54 | $194.98 |
CareSource Setting Facility Modifier None Typical Low $91.20 Median $147.91 Typical High $1,737.80 | Facility | None | $91.20 | $147.91 | $1,737.80 |
CareSource Setting Professional Modifier None Typical Low $93.33 Median $125.89 Typical High $154.88 | Professional | None | $93.33 | $125.89 | $154.88 |
Cigna Setting Facility Modifier None Typical Low $151.36 Median $1,258.93 Typical High $1,862.09 | Facility | None | $151.36 | $1,258.93 | $1,862.09 |
Cigna Setting Professional Modifier None Typical Low $95.50 Median $131.83 Typical High $741.31 | Professional | None | $95.50 | $131.83 | $741.31 |
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 $93.33 Median $125.89 Typical High $194.98 | Professional | None | $93.33 | $125.89 | $194.98 |
10 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 Facility Modifier 52 · Reduced service Typical Low $52.48 Median $70.79 Typical High $75.86 | Facility | 52 · Reduced service | $52.48 | $70.79 | $75.86 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $21.38 Median $28.18 Typical High $30.20 | Facility | 53 · Discontinued | $21.38 | $28.18 | $30.20 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $79.43 Median $107.15 Typical High $112.20 | Facility | 54 · Surgery only | $79.43 | $107.15 | $112.20 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $15.85 Median $21.38 Typical High $22.39 | Facility | 55 · Aftercare only | $15.85 | $21.38 | $22.39 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $10.47 Median $14.13 Typical High $15.14 | Facility | 56 · Pre-op care only | $10.47 | $14.13 | $15.14 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $52.48 Median $69.18 Typical High $75.86 | Professional | 52 · Reduced service | $52.48 | $69.18 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $28.18 Typical High $30.20 | Professional | 53 · Discontinued | $21.38 | $28.18 | $30.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $79.43 Median $104.71 Typical High $112.20 | Professional | 54 · Surgery only | $79.43 | $104.71 | $112.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $20.89 Typical High $22.39 | Professional | 55 · Aftercare only | $15.85 | $20.89 | $22.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $13.80 Typical High $15.14 | Professional | 56 · Pre-op care only | $10.47 | $13.80 | $15.14 |
Where Kentucky sits
The same service costs 10.9 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 $3,950MT $363
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.