How much rates vary
Facilitymedian $1,660 · 10th to 90th $427 to $5,754Professionalmedian $417 · 10th to 90th $316 to $794
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 $457.09 Median $2,570.40 Typical High $8,317.64 | Facility | None | $457.09 | $2,570.40 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $354.81 Median $575.44 Typical High $891.25 | Professional | None | $354.81 | $575.44 | $891.25 |
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 $316.23 Median $380.19 Typical High $457.09 | Professional | None | $316.23 | $380.19 | $457.09 |
CareFirst Setting Professional Modifier None Typical Low $331.13 Median $363.08 Typical High $478.63 | Professional | None | $331.13 | $363.08 | $478.63 |
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 $331.13 Median $512.86 Typical High $831.76 | Professional | None | $331.13 | $512.86 | $831.76 |
Kaiser Permanente Setting Professional Modifier None Typical Low $575.44 Median $691.83 Typical High $870.96 | Professional | None | $575.44 | $691.83 | $870.96 |
Medcost Setting Professional Modifier None Typical Low $812.83 Median $1,023.29 Typical High $1,023.29 | Professional | None | $812.83 | $1,023.29 | $1,023.29 |
Medcost Setting Facility Modifier None Typical Low $371.54 Median $575.44 Typical High $954.99 | Facility | None | $371.54 | $575.44 | $954.99 |
Medcost Setting Professional Modifier None Typical Low $288.40 Median $302.00 Typical High $676.08 | Professional | None | $288.40 | $302.00 | $676.08 |
Sentara Setting Facility Modifier None Typical Low $331.13 Median $1,071.52 Typical High $3,630.78 | Facility | None | $331.13 | $1,071.52 | $3,630.78 |
Sentara Setting Professional Modifier None Typical Low $512.86 Median $691.83 Typical High $1,318.26 | Professional | None | $512.86 | $691.83 | $1,318.26 |
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 $257.04 Median $478.63 Typical High $912.01 | Professional | None | $257.04 | $478.63 | $912.01 |
6 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 $177.83 Median $257.04 Typical High $302.00 | Professional | 52 · Reduced service | $177.83 | $257.04 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $102.33 Typical High $120.23 | Professional | 53 · Discontinued | $70.79 | $102.33 | $120.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $380.19 Typical High $446.68 | Professional | 54 · Surgery only | $263.03 | $380.19 | $446.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $75.86 Typical High $89.13 | Professional | 55 · Aftercare only | $52.48 | $75.86 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $51.29 Typical High $60.26 | Professional | 56 · Pre-op care only | $35.48 | $51.29 | $60.26 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $245.47 Median $354.81 Typical High $416.87 | Professional | 78 · Unplanned return to OR | $245.47 | $354.81 | $416.87 |
Where Virginia sits
The same service costs 4.4 times more in Colorado than in West Virginia. 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 $4,828WV $1,100
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.