How much rates vary
Facilitymedian $3,388 · 10th to 90th $214 to $10,000Professionalmedian $186 · 10th to 90th $151 to $288
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 $346.74 Median $4,786.30 Typical High $10,000.00 | Facility | None | $346.74 | $4,786.30 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $3,467.37 | Professional | None | $181.97 | $181.97 | $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 $151.36 Median $177.83 Typical High $229.09 | Professional | None | $151.36 | $177.83 | $229.09 |
CareFirst Setting Professional Modifier None Typical Low $154.88 Median $173.78 Typical High $4,365.16 | Professional | None | $154.88 | $173.78 | $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 $154.88 Median $190.55 Typical High $288.40 | Professional | None | $154.88 | $190.55 | $288.40 |
Kaiser Permanente Setting Professional Modifier None Typical Low $134.90 Median $158.49 Typical High $199.53 | Professional | None | $134.90 | $158.49 | $199.53 |
Medcost Setting Professional Modifier None Typical Low $234.42 Median $288.40 Typical High $288.40 | Professional | None | $234.42 | $288.40 | $288.40 |
Medcost Setting Facility Modifier None Typical Low $181.97 Median $223.87 Typical High $295.12 | Facility | None | $181.97 | $223.87 | $295.12 |
Medcost Setting Professional Modifier None Typical Low $208.93 Median $208.93 Typical High $208.93 | Professional | None | $208.93 | $208.93 | $208.93 |
Sentara Setting Facility Modifier None Typical Low $165.96 Median $912.01 Typical High $8,709.64 | Facility | None | $165.96 | $912.01 | $8,709.64 |
Sentara Setting Professional Modifier None Typical Low $162.18 Median $213.80 Typical High $4,073.80 | Professional | None | $162.18 | $213.80 | $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 $131.83 Median $213.80 Typical High $323.59 | Professional | None | $131.83 | $213.80 | $323.59 |
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 $87.10 Median $91.20 Typical High $95.50 | Professional | 52 · Reduced service | $87.10 | $91.20 | $95.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $36.31 Typical High $38.02 | Professional | 53 · Discontinued | $34.67 | $36.31 | $38.02 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $131.83 Median $134.90 Typical High $141.25 | Professional | 54 · Surgery only | $131.83 | $134.90 | $141.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $26.92 Typical High $28.18 | Professional | 55 · Aftercare only | $26.30 | $26.92 | $28.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $18.20 Typical High $19.05 | Professional | 56 · Pre-op care only | $17.38 | $18.20 | $19.05 |
Where Virginia sits
The same service costs 13.0 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 $6,260MT $480
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.