How much rates vary
Facilitymedian $3,311 · 10th to 90th $191 to $9,772Professionalmedian $166 · 10th to 90th $135 to $257
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 $263.03 Median $4,365.16 Typical High $10,000.00 | Facility | None | $263.03 | $4,365.16 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $3,467.37 | Professional | None | $162.18 | $162.18 | $3,467.37 |
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 $134.90 Median $162.18 Typical High $204.17 | Professional | None | $134.90 | $162.18 | $204.17 |
CareFirst Setting Professional Modifier None Typical Low $141.25 Median $154.88 Typical High $4,365.16 | Professional | None | $141.25 | $154.88 | $4,365.16 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $1,698.24 Typical High $3,235.94 | Facility | None | $478.63 | $1,698.24 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $141.25 Median $169.82 Typical High $251.19 | Professional | None | $141.25 | $169.82 | $251.19 |
Kaiser Permanente Setting Professional Modifier None Typical Low $120.23 Median $144.54 Typical High $177.83 | Professional | None | $120.23 | $144.54 | $177.83 |
Medcost Setting Professional Modifier None Typical Low $204.17 Median $251.19 Typical High $251.19 | Professional | None | $204.17 | $251.19 | $251.19 |
Medcost Setting Facility Modifier None Typical Low $162.18 Median $199.53 Typical High $263.03 | Facility | None | $162.18 | $199.53 | $263.03 |
Medcost Setting Professional Modifier None Typical Low $186.21 Median $186.21 Typical High $186.21 | Professional | None | $186.21 | $186.21 | $186.21 |
Sentara Setting Facility Modifier None Typical Low $144.54 Median $912.01 Typical High $8,709.64 | Facility | None | $144.54 | $912.01 | $8,709.64 |
Sentara Setting Professional Modifier None Typical Low $144.54 Median $190.55 Typical High $4,073.80 | Professional | None | $144.54 | $190.55 | $4,073.80 |
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 $117.49 Median $190.55 Typical High $288.40 | Professional | None | $117.49 | $190.55 | $288.40 |
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 $77.62 Median $81.28 Typical High $85.11 | Professional | 52 · Reduced service | $77.62 | $81.28 | $85.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $32.36 Typical High $33.88 | Professional | 53 · Discontinued | $30.90 | $32.36 | $33.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $120.23 Typical High $128.82 | Professional | 54 · Surgery only | $117.49 | $120.23 | $128.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $23.99 Typical High $25.70 | Professional | 55 · Aftercare only | $23.44 | $23.99 | $25.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $16.22 Typical High $16.98 | Professional | 56 · Pre-op care only | $15.49 | $16.22 | $16.98 |
Where Virginia sits
The same service costs 14.3 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 $6,102MT $428
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.