How much rates vary
Facilitymedian $288 · 10th to 90th $69 to $2,692Professionalmedian $105 · 10th to 90th $55 to $166
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 $66.07 Median $158.49 Typical High $7,079.46 | Facility | None | $66.07 | $158.49 | $7,079.46 |
Aetna Setting Professional Modifier None Typical Low $57.54 Median $114.82 Typical High $199.53 | Professional | None | $57.54 | $114.82 | $199.53 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,698.24 Median $2,398.83 Typical High $2,951.21 | Facility | None | $1,698.24 | $2,398.83 | $2,951.21 |
Anthem BCBS Setting Professional Modifier None Typical Low $56.23 Median $93.33 Typical High $138.04 | Professional | None | $56.23 | $93.33 | $138.04 |
CareFirst Setting Professional Modifier None Typical Low $46.77 Median $52.48 Typical High $67.61 | Professional | None | $46.77 | $52.48 | $67.61 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $1,230.27 | Facility | None | $50.12 | $50.12 | $1,230.27 |
Cigna Setting Professional Modifier None Typical Low $54.95 Median $109.65 Typical High $177.83 | Professional | None | $54.95 | $109.65 | $177.83 |
Kaiser Permanente Setting Professional Modifier None Typical Low $125.89 Median $165.96 Typical High $199.53 | Professional | None | $125.89 | $165.96 | $199.53 |
Medcost Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $251.19 | Professional | None | $213.80 | $213.80 | $251.19 |
Medcost Setting Facility Modifier None Typical Low $66.07 Median $151.36 Typical High $199.53 | Facility | None | $66.07 | $151.36 | $199.53 |
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 $67.61 Median $288.40 Typical High $2,454.71 | Facility | None | $67.61 | $288.40 | $2,454.71 |
Sentara Setting Professional Modifier None Typical Low $114.82 Median $147.91 Typical High $1,071.52 | Professional | None | $114.82 | $147.91 | $1,071.52 |
United Setting Facility Modifier None Typical Low $100.00 Median $660.69 Typical High $2,041.74 | Facility | None | $100.00 | $660.69 | $2,041.74 |
United Setting Professional Modifier None Typical Low $56.23 Median $107.15 Typical High $199.53 | Professional | None | $56.23 | $107.15 | $199.53 |
5 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 $28.84 Median $43.65 Typical High $60.26 | Professional | 52 · Reduced service | $28.84 | $43.65 | $60.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.75 Median $17.38 Typical High $23.99 | Professional | 53 · Discontinued | $11.75 | $17.38 | $23.99 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $43.65 Median $66.07 Typical High $91.20 | Professional | 54 · Surgery only | $43.65 | $66.07 | $91.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.71 Median $13.18 Typical High $18.20 | Professional | 55 · Aftercare only | $8.71 | $13.18 | $18.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.75 Median $8.71 Typical High $12.02 | Professional | 56 · Pre-op care only | $5.75 | $8.71 | $12.02 |
Where Virginia sits
The same service costs 12.9 times more in Colorado 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
CO $2,408ME $187
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.