How much rates vary
Facilitymedian $3,090 · 10th to 90th $347 to $9,550Professionalmedian $316 · 10th to 90th $251 to $537
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 $302.00 Median $5,248.07 Typical High $10,000.00 | Facility | None | $302.00 | $5,248.07 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $275.42 Median $407.38 Typical High $467.74 | Professional | None | $275.42 | $407.38 | $467.74 |
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 $251.19 Median $302.00 Typical High $363.08 | Professional | None | $251.19 | $302.00 | $363.08 |
CareFirst Setting Professional Modifier None Typical Low $263.03 Median $295.12 Typical High $380.19 | Professional | None | $263.03 | $295.12 | $380.19 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $1,698.24 Typical High $3,090.30 | Facility | None | $524.81 | $1,698.24 | $3,090.30 |
Cigna Setting Professional Modifier None Typical Low $263.03 Median $389.05 Typical High $575.44 | Professional | None | $263.03 | $389.05 | $575.44 |
Kaiser Permanente Setting Professional Modifier None Typical Low $389.05 Median $467.74 Typical High $588.84 | Professional | None | $389.05 | $467.74 | $588.84 |
Medcost Setting Professional Modifier None Typical Low $416.87 Median $524.81 Typical High $537.03 | Professional | None | $416.87 | $524.81 | $537.03 |
Medcost Setting Facility Modifier None Typical Low $302.00 Median $467.74 Typical High $758.58 | Facility | None | $302.00 | $467.74 | $758.58 |
Medcost Setting Professional Modifier None Typical Low $407.38 Median $457.09 Typical High $478.63 | Professional | None | $407.38 | $457.09 | $478.63 |
Sentara Setting Facility Modifier None Typical Low $245.47 Median $1,202.26 Typical High $8,709.64 | Facility | None | $245.47 | $1,202.26 | $8,709.64 |
Sentara Setting Professional Modifier None Typical Low $363.08 Median $457.09 Typical High $1,000.00 | Professional | None | $363.08 | $457.09 | $1,000.00 |
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 $204.17 Median $346.74 Typical High $645.65 | Professional | None | $204.17 | $346.74 | $645.65 |
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 $134.90 Median $190.55 Typical High $234.42 | Professional | 52 · Reduced service | $134.90 | $190.55 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $75.86 Typical High $93.33 | Professional | 53 · Discontinued | $54.95 | $75.86 | $93.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $288.40 Typical High $354.81 | Professional | 54 · Surgery only | $204.17 | $288.40 | $354.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $57.54 Typical High $70.79 | Professional | 55 · Aftercare only | $40.74 | $57.54 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $38.02 Typical High $46.77 | Professional | 56 · Pre-op care only | $27.54 | $38.02 | $46.77 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $190.55 Median $269.15 Typical High $331.13 | Professional | 78 · Unplanned return to OR | $190.55 | $269.15 | $331.13 |
Where Virginia sits
The same service costs 6.3 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 $6,296MT $1,002
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.