How much rates vary
Facilitymedian $427 · 10th to 90th $105 to $3,802Professionalmedian $162 · 10th to 90th $87 to $257
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 $131.83 Median $812.83 Typical High $8,317.64 | Facility | None | $131.83 | $812.83 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $91.20 Median $177.83 Typical High $346.74 | Professional | None | $91.20 | $177.83 | $346.74 |
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 $89.13 Median $144.54 Typical High $208.93 | Professional | None | $89.13 | $144.54 | $208.93 |
CareFirst Setting Professional Modifier None Typical Low $77.62 Median $87.10 Typical High $102.33 | Professional | None | $77.62 | $87.10 | $102.33 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $114.82 Typical High $213.80 | Facility | None | $50.12 | $114.82 | $213.80 |
Cigna Setting Professional Modifier None Typical Low $91.20 Median $173.78 Typical High $288.40 | Professional | None | $91.20 | $173.78 | $288.40 |
Kaiser Permanente Setting Professional Modifier None Typical Low $190.55 Median $251.19 Typical High $302.00 | Professional | None | $190.55 | $251.19 | $302.00 |
Medcost Setting Professional Modifier None Typical Low $346.74 Median $346.74 Typical High $407.38 | Professional | None | $346.74 | $346.74 | $407.38 |
Medcost Setting Facility Modifier None Typical Low $104.71 Median $239.88 Typical High $323.59 | Facility | None | $104.71 | $239.88 | $323.59 |
Medcost Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,318.26 | Professional | None | $1,318.26 | $1,318.26 | $1,318.26 |
Sentara Setting Facility Modifier None Typical Low $107.15 Median $302.00 Typical High $2,454.71 | Facility | None | $107.15 | $302.00 | $2,454.71 |
Sentara Setting Professional Modifier None Typical Low $181.97 Median $234.42 Typical High $1,071.52 | Professional | None | $181.97 | $234.42 | $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 $89.13 Median $169.82 Typical High $309.03 | Professional | None | $89.13 | $169.82 | $309.03 |
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 $45.71 Median $64.57 Typical High $91.20 | Professional | 52 · Reduced service | $45.71 | $64.57 | $91.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.62 Median $26.30 Typical High $36.31 | Professional | 53 · Discontinued | $18.62 | $26.30 | $36.31 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $69.18 Median $97.72 Typical High $138.04 | Professional | 54 · Surgery only | $69.18 | $97.72 | $138.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $19.50 Typical High $27.54 | Professional | 55 · Aftercare only | $13.80 | $19.50 | $27.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $12.88 Typical High $18.20 | Professional | 56 · Pre-op care only | $9.12 | $12.88 | $18.20 |
Where Virginia sits
The same service costs 11.6 times more in Hawaii than in Maryland. 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
HI $3,027MD $261
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.