How much rates vary
Facilitymedian $1,995 · 10th to 90th $302 to $6,026Professionalmedian $263 · 10th to 90th $200 to $372
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 $275.42 Median $4,786.30 Typical High $14,125.38 | Facility | None | $275.42 | $4,786.30 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $251.19 Median $275.42 Typical High $338.84 | Professional | None | $251.19 | $275.42 | $338.84 |
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 $223.87 Median $269.15 Typical High $323.59 | Professional | None | $223.87 | $269.15 | $323.59 |
CareFirst Setting Professional Modifier None Typical Low $190.55 Median $213.80 Typical High $275.42 | Professional | None | $190.55 | $213.80 | $275.42 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $1,023.29 Typical High $2,691.53 | Facility | None | $512.86 | $1,023.29 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $218.78 Median $239.88 Typical High $371.54 | Professional | None | $218.78 | $239.88 | $371.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $199.53 Median $239.88 Typical High $302.00 | Professional | None | $199.53 | $239.88 | $302.00 |
Medcost Setting Professional Modifier None Typical Low $309.03 Median $389.05 Typical High $389.05 | Professional | None | $309.03 | $389.05 | $389.05 |
Medcost Setting Facility Modifier None Typical Low $275.42 Median $316.23 Typical High $446.68 | Facility | None | $275.42 | $316.23 | $446.68 |
Medcost Setting Professional Modifier None Typical Low $177.83 Median $208.93 Typical High $302.00 | Professional | None | $177.83 | $208.93 | $302.00 |
Sentara Setting Facility Modifier None Typical Low $165.96 Median $1,023.29 Typical High $3,630.78 | Facility | None | $165.96 | $1,023.29 | $3,630.78 |
Sentara Setting Professional Modifier None Typical Low $173.78 Median $295.12 Typical High $588.84 | Professional | None | $173.78 | $295.12 | $588.84 |
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 $165.96 Median $223.87 Typical High $426.58 | Professional | None | $165.96 | $223.87 | $426.58 |
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 $123.03 Median $138.04 Typical High $138.04 | Professional | 52 · Reduced service | $123.03 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $54.95 Typical High $54.95 | Professional | 53 · Discontinued | $50.12 | $54.95 | $54.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $204.17 Typical High $204.17 | Professional | 54 · Surgery only | $186.21 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $41.69 Typical High $41.69 | Professional | 55 · Aftercare only | $37.15 | $41.69 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $27.54 Typical High $27.54 | Professional | 56 · Pre-op care only | $25.12 | $27.54 | $27.54 |
Where Virginia sits
The same service costs 6.2 times more in Colorado 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
CO $4,689MT $752
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.