How much rates vary
Facilitymedian $1,950 · 10th to 90th $295 to $6,026Professionalmedian $309 · 10th to 90th $204 to $447
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 $257.04 Median $4,365.16 Typical High $10,000.00 | Facility | None | $257.04 | $4,365.16 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $223.87 Median $295.12 Typical High $501.19 | Professional | None | $223.87 | $295.12 | $501.19 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,884.03 Median $3,715.35 Typical High $4,265.80 | Facility | None | $2,884.03 | $3,715.35 | $4,265.80 |
Anthem BCBS Setting Professional Modifier None Typical Low $204.17 Median $295.12 Typical High $416.87 | Professional | None | $204.17 | $295.12 | $416.87 |
CareFirst Setting Professional Modifier None Typical Low $204.17 Median $229.09 Typical High $269.15 | Professional | None | $204.17 | $229.09 | $269.15 |
Cigna Setting Facility Modifier None Typical Low $389.05 Median $1,258.93 Typical High $2,187.76 | Facility | None | $389.05 | $1,258.93 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $208.93 Median $323.59 Typical High $446.68 | Professional | None | $208.93 | $323.59 | $446.68 |
Kaiser Permanente Setting Professional Modifier None Typical Low $323.59 Median $426.58 Typical High $512.86 | Professional | None | $323.59 | $426.58 | $512.86 |
Medcost Setting Facility Modifier None Typical Low $257.04 Median $371.54 Typical High $616.60 | Facility | None | $257.04 | $371.54 | $616.60 |
Medcost Setting Professional Modifier None Typical Low $223.87 Median $223.87 Typical High $223.87 | Professional | None | $223.87 | $223.87 | $223.87 |
Sentara Setting Facility Modifier None Typical Low $208.93 Median $1,023.29 Typical High $5,011.87 | Facility | None | $208.93 | $1,023.29 | $5,011.87 |
Sentara Setting Professional Modifier None Typical Low $331.13 Median $389.05 Typical High $2,570.40 | Professional | None | $331.13 | $389.05 | $2,570.40 |
United Setting Facility Modifier None Typical Low $588.84 Median $2,187.76 Typical High $5,888.44 | Facility | None | $588.84 | $2,187.76 | $5,888.44 |
United Setting Professional Modifier None Typical Low $199.53 Median $323.59 Typical High $524.81 | Professional | None | $199.53 | $323.59 | $524.81 |
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 $112.20 Median $134.90 Typical High $186.21 | Professional | 52 · Reduced service | $112.20 | $134.90 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $53.70 Typical High $74.13 | Professional | 53 · Discontinued | $44.67 | $53.70 | $74.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $165.96 Median $204.17 Typical High $281.84 | Professional | 54 · Surgery only | $165.96 | $204.17 | $281.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $40.74 Typical High $56.23 | Professional | 55 · Aftercare only | $33.11 | $40.74 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $26.92 Typical High $37.15 | Professional | 56 · Pre-op care only | $22.39 | $26.92 | $37.15 |
Where Virginia sits
The same service costs 6.1 times more in Michigan 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
MI $4,783MT $790
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.