How much rates vary
Facilitymedian $603 · 10th to 90th $145 to $4,074Professionalmedian $204 · 10th to 90th $120 to $324
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 $213.80 Median $3,981.07 Typical High $9,332.54 | Facility | None | $213.80 | $3,981.07 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $125.89 Median $229.09 Typical High $457.09 | Professional | None | $125.89 | $229.09 | $457.09 |
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 $120.23 Median $181.97 Typical High $269.15 | Professional | None | $120.23 | $181.97 | $269.15 |
CareFirst Setting Professional Modifier None Typical Low $107.15 Median $117.49 Typical High $138.04 | Professional | None | $107.15 | $117.49 | $138.04 |
Cigna Setting Facility Modifier None Typical Low $229.09 Median $446.68 Typical High $2,187.76 | Facility | None | $229.09 | $446.68 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $123.03 Median $223.87 Typical High $354.81 | Professional | None | $123.03 | $223.87 | $354.81 |
Kaiser Permanente Setting Professional Modifier None Typical Low $245.47 Median $316.23 Typical High $380.19 | Professional | None | $245.47 | $316.23 | $380.19 |
Medcost Setting Professional Modifier None Typical Low $416.87 Median $416.87 Typical High $489.78 | Professional | None | $416.87 | $416.87 | $489.78 |
Medcost Setting Facility Modifier None Typical Low $144.54 Median $295.12 Typical High $389.05 | Facility | None | $144.54 | $295.12 | $389.05 |
Medcost Setting Professional Modifier None Typical Low $1,548.82 Median $1,548.82 Typical High $1,548.82 | Professional | None | $1,548.82 | $1,548.82 | $1,548.82 |
Sentara Setting Facility Modifier None Typical Low $144.54 Median $338.84 Typical High $2,454.71 | Facility | None | $144.54 | $338.84 | $2,454.71 |
Sentara Setting Professional Modifier None Typical Low $223.87 Median $281.84 Typical High $1,122.02 | Professional | None | $223.87 | $281.84 | $1,122.02 |
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 $120.23 Median $218.78 Typical High $389.05 | Professional | None | $120.23 | $218.78 | $389.05 |
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 $63.10 Median $85.11 Typical High $114.82 | Professional | 52 · Reduced service | $63.10 | $85.11 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $33.11 Typical High $46.77 | Professional | 53 · Discontinued | $25.12 | $33.11 | $46.77 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $93.33 Median $123.03 Typical High $173.78 | Professional | 54 · Surgery only | $93.33 | $123.03 | $173.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $25.70 Typical High $34.67 | Professional | 55 · Aftercare only | $18.62 | $25.70 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $16.60 Typical High $22.91 | Professional | 56 · Pre-op care only | $12.59 | $16.60 | $22.91 |
Where Virginia sits
The same service costs 7.2 times more in New York than in Michigan. 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
NY $2,740MI $382
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.