How much rates vary
Facilitymedian $2,089 · 10th to 90th $479 to $6,166Professionalmedian $490 · 10th to 90th $380 to $692
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 $489.78 Median $5,370.32 Typical High $14,125.38 | Facility | None | $489.78 | $5,370.32 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $436.52 Median $446.68 Typical High $794.33 | Professional | None | $436.52 | $446.68 | $794.33 |
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 $426.58 Median $512.86 Typical High $616.60 | Professional | None | $426.58 | $512.86 | $616.60 |
CareFirst Setting Professional Modifier None Typical Low $457.09 Median $512.86 Typical High $676.08 | Professional | None | $457.09 | $512.86 | $676.08 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $1,023.29 Typical High $2,570.40 | Facility | None | $524.81 | $1,023.29 | $2,570.40 |
Cigna Setting Professional Modifier None Typical Low $371.54 Median $457.09 Typical High $691.83 | Professional | None | $371.54 | $457.09 | $691.83 |
Kaiser Permanente Setting Professional Modifier None Typical Low $436.52 Median $524.81 Typical High $660.69 | Professional | None | $436.52 | $524.81 | $660.69 |
Medcost Setting Professional Modifier None Typical Low $537.03 Median $660.69 Typical High $660.69 | Professional | None | $537.03 | $660.69 | $660.69 |
Medcost Setting Facility Modifier None Typical Low $436.52 Median $489.78 Typical High $707.95 | Facility | None | $436.52 | $489.78 | $707.95 |
Medcost Setting Professional Modifier None Typical Low $302.00 Median $398.11 Typical High $457.09 | Professional | None | $302.00 | $398.11 | $457.09 |
Sentara Setting Facility Modifier None Typical Low $389.05 Median $1,071.52 Typical High $3,630.78 | Facility | None | $389.05 | $1,071.52 | $3,630.78 |
Sentara Setting Professional Modifier None Typical Low $380.19 Median $478.63 Typical High $1,071.52 | Professional | None | $380.19 | $478.63 | $1,071.52 |
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 $295.12 Median $380.19 Typical High $741.31 | Professional | None | $295.12 | $380.19 | $741.31 |
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 $218.78 Median $218.78 Typical High $245.47 | Professional | 52 · Reduced service | $218.78 | $218.78 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $87.10 Median $87.10 Typical High $97.72 | Professional | 53 · Discontinued | $87.10 | $87.10 | $97.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $323.59 Median $323.59 Typical High $371.54 | Professional | 54 · Surgery only | $323.59 | $323.59 | $371.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $64.57 Typical High $74.13 | Professional | 55 · Aftercare only | $64.57 | $64.57 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $43.65 Typical High $48.98 | Professional | 56 · Pre-op care only | $43.65 | $43.65 | $48.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $302.00 Median $302.00 Typical High $346.74 | Professional | 78 · Unplanned return to OR | $302.00 | $302.00 | $346.74 |
Where Virginia sits
The same service costs 4.2 times more in Colorado than in Delaware. 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 $4,996DE $1,192
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.