How much rates vary
Facilitymedian $5,495 · 10th to 90th $525 to $12,882Professionalmedian $513 · 10th to 90th $407 to $813
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 $524.81 Median $7,413.10 Typical High $14,125.38 | Facility | None | $524.81 | $7,413.10 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $489.78 Median $524.81 Typical High $3,801.89 | Professional | None | $489.78 | $524.81 | $3,801.89 |
Anthem BCBS Setting Facility Modifier None Typical Low $8,912.51 Median $11,220.18 Typical High $17,378.01 | Facility | None | $8,912.51 | $11,220.18 | $17,378.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $416.87 Median $501.19 Typical High $630.96 | Professional | None | $416.87 | $501.19 | $630.96 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $616.60 Median $741.31 Typical High $954.99 | Professional | 50 · Both sides | $616.60 | $741.31 | $954.99 |
CareFirst Setting Professional Modifier None Typical Low $407.38 Median $457.09 Typical High $7,079.46 | Professional | None | $407.38 | $457.09 | $7,079.46 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $2,754.23 Typical High $5,495.41 | Facility | None | $524.81 | $2,754.23 | $5,495.41 |
Cigna Setting Professional Modifier None Typical Low $426.58 Median $512.86 Typical High $758.58 | Professional | None | $426.58 | $512.86 | $758.58 |
Kaiser Permanente Setting Professional Modifier None Typical Low $363.08 Median $426.58 Typical High $537.03 | Professional | None | $363.08 | $426.58 | $537.03 |
Medcost Setting Facility Modifier None Typical Low $501.19 Median $602.56 Typical High $831.76 | Facility | None | $501.19 | $602.56 | $831.76 |
Medcost Setting Professional Modifier None Typical Low $602.56 Median $602.56 Typical High $602.56 | Professional | None | $602.56 | $602.56 | $602.56 |
Sentara Setting Facility Modifier None Typical Low $457.09 Median $1,819.70 Typical High $10,232.93 | Facility | None | $457.09 | $1,819.70 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $446.68 Median $588.84 Typical High $6,025.60 | Professional | None | $446.68 | $588.84 | $6,025.60 |
United Setting Facility Modifier None Typical Low $1,548.82 Median $6,760.83 Typical High $17,378.01 | Facility | None | $1,548.82 | $6,760.83 | $17,378.01 |
United Setting Professional Modifier None Typical Low $371.54 Median $602.56 Typical High $912.01 | Professional | None | $371.54 | $602.56 | $912.01 |
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 $239.88 Median $251.19 Typical High $263.03 | Professional | 52 · Reduced service | $239.88 | $251.19 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $100.00 Typical High $104.71 | Professional | 53 · Discontinued | $95.50 | $100.00 | $104.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $380.19 Typical High $389.05 | Professional | 54 · Surgery only | $363.08 | $380.19 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $75.86 Typical High $77.62 | Professional | 55 · Aftercare only | $72.44 | $75.86 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $50.12 Typical High $52.48 | Professional | 56 · Pre-op care only | $47.86 | $50.12 | $52.48 |
Where Virginia sits
The same service costs 8.9 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 $11,610MT $1,306
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.