How much rates vary
Facilitymedian $2,818 · 10th to 90th $501 to $9,550Professionalmedian $468 · 10th to 90th $363 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 $562.34 Median $4,073.80 Typical High $9,332.54 | Facility | None | $562.34 | $4,073.80 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $562.34 Typical High $870.96 | Professional | None | $407.38 | $562.34 | $870.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,677.35 Median $6,456.54 Typical High $7,244.36 | Facility | None | $4,677.35 | $6,456.54 | $7,244.36 |
Anthem BCBS Setting Professional Modifier None Typical Low $371.54 Median $436.52 Typical High $537.03 | Professional | None | $371.54 | $436.52 | $537.03 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $549.54 Median $660.69 Typical High $794.33 | Professional | 50 · Both sides | $549.54 | $660.69 | $794.33 |
CareFirst Setting Professional Modifier None Typical Low $389.05 Median $436.52 Typical High $562.34 | Professional | None | $389.05 | $436.52 | $562.34 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $1,288.25 Typical High $2,344.23 | Facility | None | $478.63 | $1,288.25 | $2,344.23 |
Cigna Setting Professional Modifier None Typical Low $380.19 Median $512.86 Typical High $776.25 | Professional | None | $380.19 | $512.86 | $776.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $524.81 Median $630.96 Typical High $812.83 | Professional | None | $524.81 | $630.96 | $812.83 |
Medcost Setting Professional Modifier None Typical Low $645.65 Median $794.33 Typical High $912.01 | Professional | None | $645.65 | $794.33 | $912.01 |
Medcost Setting Facility Modifier None Typical Low $436.52 Median $602.56 Typical High $977.24 | Facility | None | $436.52 | $602.56 | $977.24 |
Medcost Setting Professional Modifier None Typical Low $251.19 Median $524.81 Typical High $630.96 | Professional | None | $251.19 | $524.81 | $630.96 |
Sentara Setting Facility Modifier None Typical Low $354.81 Median $1,445.44 Typical High $8,709.64 | Facility | None | $354.81 | $1,445.44 | $8,709.64 |
Sentara Setting Professional Modifier None Typical Low $524.81 Median $691.83 Typical High $1,288.25 | Professional | None | $524.81 | $691.83 | $1,288.25 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $5,011.87 Typical High $13,182.57 | Facility | None | $1,230.27 | $5,011.87 | $13,182.57 |
United Setting Professional Modifier None Typical Low $295.12 Median $467.74 Typical High $870.96 | Professional | None | $295.12 | $467.74 | $870.96 |
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 $204.17 Median $257.04 Typical High $295.12 | Professional | 52 · Reduced service | $204.17 | $257.04 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $102.33 Typical High $120.23 | Professional | 53 · Discontinued | $81.28 | $102.33 | $120.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $380.19 Typical High $446.68 | Professional | 54 · Surgery only | $309.03 | $380.19 | $446.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $75.86 Typical High $89.13 | Professional | 55 · Aftercare only | $61.66 | $75.86 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $51.29 Typical High $60.26 | Professional | 56 · Pre-op care only | $40.74 | $51.29 | $60.26 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $354.81 Typical High $416.87 | Professional | 78 · Unplanned return to OR | $288.40 | $354.81 | $416.87 |
Where Virginia sits
The same service costs 4.7 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 $6,464MT $1,390
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.