How much rates vary
Facilitymedian $2,239 · 10th to 90th $389 to $9,120Professionalmedian $380 · 10th to 90th $275 to $550
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 $407.38 Median $724.44 Typical High $8,317.64 | Facility | None | $407.38 | $724.44 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $295.12 Median $416.87 Typical High $645.65 | Professional | None | $295.12 | $416.87 | $645.65 |
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 $269.15 Median $380.19 Typical High $524.81 | Professional | None | $269.15 | $380.19 | $524.81 |
CareFirst Setting Professional Modifier None Typical Low $275.42 Median $309.03 Typical High $363.08 | Professional | None | $275.42 | $309.03 | $363.08 |
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 $275.42 Median $389.05 Typical High $549.54 | Professional | None | $275.42 | $389.05 | $549.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $380.19 Median $501.19 Typical High $588.84 | Professional | None | $380.19 | $501.19 | $588.84 |
Medcost Setting Professional Modifier None Typical Low $489.78 Median $489.78 Typical High $575.44 | Professional | None | $489.78 | $489.78 | $575.44 |
Medcost Setting Facility Modifier None Typical Low $331.13 Median $457.09 Typical High $741.31 | Facility | None | $331.13 | $457.09 | $741.31 |
Medcost Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $812.83 | Professional | None | $812.83 | $812.83 | $812.83 |
Sentara Setting Facility Modifier None Typical Low $257.04 Median $1,096.48 Typical High $8,709.64 | Facility | None | $257.04 | $1,096.48 | $8,709.64 |
Sentara Setting Professional Modifier None Typical Low $288.40 Median $478.63 Typical High $5,128.61 | Professional | None | $288.40 | $478.63 | $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 $245.47 Median $380.19 Typical High $660.69 | Professional | None | $245.47 | $380.19 | $660.69 |
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 $144.54 Median $169.82 Typical High $229.09 | Professional | 52 · Reduced service | $144.54 | $169.82 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $58.88 Median $67.61 Typical High $91.20 | Professional | 53 · Discontinued | $58.88 | $67.61 | $91.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $218.78 Median $251.19 Typical High $338.84 | Professional | 54 · Surgery only | $218.78 | $251.19 | $338.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $43.65 Median $50.12 Typical High $67.61 | Professional | 55 · Aftercare only | $43.65 | $50.12 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $33.88 Typical High $45.71 | Professional | 56 · Pre-op care only | $29.51 | $33.88 | $45.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $204.17 Median $234.42 Typical High $316.23 | Professional | 78 · Unplanned return to OR | $204.17 | $234.42 | $316.23 |
Where Virginia sits
The same service costs 6.1 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 $6,346MT $1,043
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.