How much rates vary
Facilitymedian $1,445 · 10th to 90th $158 to $5,623Professionalmedian $295 · 10th to 90th $120 to $617
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 $147.91 Median $954.99 Typical High $7,244.36 | Facility | None | $147.91 | $954.99 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $120.23 Median $389.05 Typical High $707.95 | Professional | None | $120.23 | $389.05 | $707.95 |
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 $123.03 Median $229.09 Typical High $489.78 | Professional | None | $123.03 | $229.09 | $489.78 |
CareFirst Setting Professional Modifier None Typical Low $123.03 Median $138.04 Typical High $177.83 | Professional | None | $123.03 | $138.04 | $177.83 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $870.96 Typical High $2,187.76 | Facility | None | $478.63 | $870.96 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $123.03 Median $309.03 Typical High $758.58 | Professional | None | $123.03 | $309.03 | $758.58 |
Kaiser Permanente Setting Professional Modifier None Typical Low $354.81 Median $426.58 Typical High $549.54 | Professional | None | $354.81 | $426.58 | $549.54 |
Medcost Setting Professional Modifier None Typical Low $363.08 Median $1,479.11 Typical High $1,479.11 | Professional | None | $363.08 | $1,479.11 | $1,479.11 |
Medcost Setting Facility Modifier None Typical Low $120.23 Median $194.98 Typical High $933.25 | Facility | None | $120.23 | $194.98 | $933.25 |
Medcost Setting Professional Modifier None Typical Low $199.53 Median $229.09 Typical High $776.25 | Professional | None | $199.53 | $229.09 | $776.25 |
Sentara Setting Facility Modifier None Typical Low $112.20 Median $912.01 Typical High $3,630.78 | Facility | None | $112.20 | $912.01 | $3,630.78 |
Sentara Setting Professional Modifier None Typical Low $199.53 Median $630.96 Typical High $1,288.25 | Professional | None | $199.53 | $630.96 | $1,288.25 |
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 $95.50 Median $275.42 Typical High $891.25 | Professional | None | $95.50 | $275.42 | $891.25 |
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 $60.26 Median $173.78 Typical High $288.40 | Professional | 52 · Reduced service | $60.26 | $173.78 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $69.18 Typical High $114.82 | Professional | 53 · Discontinued | $23.99 | $69.18 | $114.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $91.20 Median $257.04 Typical High $436.52 | Professional | 54 · Surgery only | $91.20 | $257.04 | $436.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $51.29 Typical High $87.10 | Professional | 55 · Aftercare only | $18.20 | $51.29 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $34.67 Typical High $57.54 | Professional | 56 · Pre-op care only | $12.02 | $34.67 | $57.54 |
Where Virginia sits
The same service costs 5.1 times more in Colorado than in North Dakota. 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 $4,353ND $853
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.