How much rates vary
Facilitymedian $1,230 · 10th to 90th $105 to $4,898Professionalmedian $331 · 10th to 90th $83 to $646
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 $97.72 Median $3,235.94 Typical High $8,317.64 | Facility | None | $97.72 | $3,235.94 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $83.18 Median $371.54 Typical High $741.31 | Professional | None | $83.18 | $371.54 | $741.31 |
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 $81.28 Median $204.17 Typical High $467.74 | Professional | None | $81.28 | $204.17 | $467.74 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $123.03 Median $302.00 Typical High $707.95 | Professional | 50 · Both sides | $123.03 | $302.00 | $707.95 |
CareFirst Setting Professional Modifier None Typical Low $91.20 Median $100.00 Typical High $1,659.59 | Professional | None | $91.20 | $100.00 | $1,659.59 |
Cigna Setting Facility Modifier None Typical Low $338.84 Median $707.95 Typical High $2,187.76 | Facility | None | $338.84 | $707.95 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $83.18 Median $295.12 Typical High $676.08 | Professional | None | $83.18 | $295.12 | $676.08 |
Kaiser Permanente Setting Professional Modifier None Typical Low $69.18 Median $416.87 Typical High $512.86 | Professional | None | $69.18 | $416.87 | $512.86 |
Medcost Setting Facility Modifier None Typical Low $97.72 Median $162.18 Typical High $891.25 | Facility | None | $97.72 | $162.18 | $891.25 |
Medcost Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $616.60 | Professional | None | $616.60 | $616.60 | $616.60 |
Sentara Setting Facility Modifier None Typical Low $87.10 Median $616.60 Typical High $2,951.21 | Facility | None | $87.10 | $616.60 | $2,951.21 |
Sentara Setting Professional Modifier None Typical Low $436.52 Median $588.84 Typical High $2,041.74 | Professional | None | $436.52 | $588.84 | $2,041.74 |
United Setting Facility Modifier None Typical Low $323.59 Median $1,445.44 Typical High $3,630.78 | Facility | None | $323.59 | $1,445.44 | $3,630.78 |
United Setting Professional Modifier None Typical Low $74.13 Median $257.04 Typical High $831.76 | Professional | None | $74.13 | $257.04 | $831.76 |
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 $41.69 Median $61.66 Typical High $269.15 | Professional | 52 · Reduced service | $41.69 | $61.66 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $24.55 Typical High $107.15 | Professional | 53 · Discontinued | $16.60 | $24.55 | $107.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $61.66 Median $93.33 Typical High $407.38 | Professional | 54 · Surgery only | $61.66 | $93.33 | $407.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $18.62 Typical High $81.28 | Professional | 55 · Aftercare only | $12.30 | $18.62 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $30.20 Typical High $53.70 | Professional | 56 · Pre-op care only | $8.32 | $30.20 | $53.70 |
Where Virginia sits
The same service costs 5.5 times more in Connecticut 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
CT $3,114MT $570
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.