How much rates vary
Facilitymedian $2,344 · 10th to 90th $234 to $9,333Professionalmedian $245 · 10th to 90th $170 to $355
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 $245.47 Median $549.54 Typical High $8,317.64 | Facility | None | $245.47 | $549.54 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $181.97 Median $275.42 Typical High $416.87 | Professional | None | $181.97 | $275.42 | $416.87 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,677.35 Median $6,456.54 Typical High $7,244.36 | Facility | None | $4,677.35 | $6,456.54 | $7,244.36 |
Anthem BCBS Setting Professional Modifier None Typical Low $169.82 Median $239.88 Typical High $331.13 | Professional | None | $169.82 | $239.88 | $331.13 |
CareFirst Setting Professional Modifier None Typical Low $173.78 Median $194.98 Typical High $229.09 | Professional | None | $173.78 | $194.98 | $229.09 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $1,288.25 Typical High $2,344.23 | Facility | None | $478.63 | $1,288.25 | $2,344.23 |
Cigna Setting Professional Modifier None Typical Low $181.97 Median $257.04 Typical High $354.81 | Professional | None | $181.97 | $257.04 | $354.81 |
Kaiser Permanente Setting Professional Modifier None Typical Low $263.03 Median $346.74 Typical High $407.38 | Professional | None | $263.03 | $346.74 | $407.38 |
Medcost Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $346.74 | Professional | None | $302.00 | $302.00 | $346.74 |
Medcost Setting Facility Modifier None Typical Low $199.53 Median $275.42 Typical High $457.09 | Facility | None | $199.53 | $275.42 | $457.09 |
Medcost Setting Professional Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,174.90 | Professional | None | $1,174.90 | $1,174.90 | $1,174.90 |
Sentara Setting Facility Modifier None Typical Low $162.18 Median $933.25 Typical High $8,709.64 | Facility | None | $162.18 | $933.25 | $8,709.64 |
Sentara Setting Professional Modifier None Typical Low $169.82 Median $295.12 Typical High $5,128.61 | Professional | None | $169.82 | $295.12 | $5,128.61 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $5,011.87 Typical High $13,182.57 | Facility | None | $1,230.27 | $5,011.87 | $13,182.57 |
United Setting Professional Modifier None Typical Low $154.88 Median $234.42 Typical High $398.11 | Professional | None | $154.88 | $234.42 | $398.11 |
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 $91.20 Median $107.15 Typical High $138.04 | Professional | 52 · Reduced service | $91.20 | $107.15 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $42.66 Typical High $56.23 | Professional | 53 · Discontinued | $36.31 | $42.66 | $56.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $158.49 Typical High $208.93 | Professional | 54 · Surgery only | $138.04 | $158.49 | $208.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $31.62 Typical High $41.69 | Professional | 55 · Aftercare only | $27.54 | $31.62 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $21.38 Typical High $27.54 | Professional | 56 · Pre-op care only | $18.20 | $21.38 | $27.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $128.82 Median $147.91 Typical High $194.98 | Professional | 78 · Unplanned return to OR | $128.82 | $147.91 | $194.98 |
Where Virginia sits
The same service costs 9.3 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 $5,912MT $637
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.