How much rates vary
Facilitymedian $2,239 · 10th to 90th $525 to $9,120Professionalmedian $589 · 10th to 90th $427 to $832
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 $575.44 Median $831.76 Typical High $8,317.64 | Facility | None | $575.44 | $831.76 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $457.09 Median $660.69 Typical High $1,023.29 | Professional | None | $457.09 | $660.69 | $1,023.29 |
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 $436.52 Median $588.84 Typical High $812.83 | Professional | None | $436.52 | $588.84 | $812.83 |
CareFirst Setting Professional Modifier None Typical Low $436.52 Median $489.78 Typical High $575.44 | Professional | None | $436.52 | $489.78 | $575.44 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $1,318.26 Typical High $2,691.53 | Facility | None | $524.81 | $1,318.26 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $436.52 Median $602.56 Typical High $831.76 | Professional | None | $436.52 | $602.56 | $831.76 |
Kaiser Permanente Setting Professional Modifier None Typical Low $630.96 Median $831.76 Typical High $977.24 | Professional | None | $630.96 | $831.76 | $977.24 |
Medcost Setting Professional Modifier None Typical Low $630.96 Median $630.96 Typical High $758.58 | Professional | None | $630.96 | $630.96 | $758.58 |
Medcost Setting Facility Modifier None Typical Low $489.78 Median $660.69 Typical High $1,071.52 | Facility | None | $489.78 | $660.69 | $1,071.52 |
Medcost Setting Professional Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,047.13 | Professional | None | $1,047.13 | $1,047.13 | $1,047.13 |
Sentara Setting Facility Modifier None Typical Low $354.81 Median $1,621.81 Typical High $8,709.64 | Facility | None | $354.81 | $1,621.81 | $8,709.64 |
Sentara Setting Professional Modifier None Typical Low $436.52 Median $676.08 Typical High $5,128.61 | Professional | None | $436.52 | $676.08 | $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 $363.08 Median $549.54 Typical High $933.25 | Professional | None | $363.08 | $549.54 | $933.25 |
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 $229.09 Median $251.19 Typical High $331.13 | Professional | 52 · Reduced service | $229.09 | $251.19 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $100.00 Typical High $131.83 | Professional | 53 · Discontinued | $91.20 | $100.00 | $131.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $346.74 Median $380.19 Typical High $489.78 | Professional | 54 · Surgery only | $346.74 | $380.19 | $489.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $75.86 Typical High $97.72 | Professional | 55 · Aftercare only | $69.18 | $75.86 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $50.12 Typical High $66.07 | Professional | 56 · Pre-op care only | $45.71 | $50.12 | $66.07 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $323.59 Median $354.81 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $323.59 | $354.81 | $457.09 |
Where Virginia sits
The same service costs 5.2 times more in Colorado than in West Virginia. 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 $6,580WV $1,277
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.