How much rates vary
Facilitymedian $3,311 · 10th to 90th $331 to $9,772Professionalmedian $288 · 10th to 90th $229 to $457
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 $446.68 Median $4,365.16 Typical High $10,000.00 | Facility | None | $446.68 | $4,365.16 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $281.84 Median $295.12 Typical High $3,162.28 | Professional | None | $281.84 | $295.12 | $3,162.28 |
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 $229.09 Median $275.42 Typical High $354.81 | Professional | None | $229.09 | $275.42 | $354.81 |
CareFirst Setting Professional Modifier None Typical Low $239.88 Median $269.15 Typical High $3,548.13 | Professional | None | $239.88 | $269.15 | $3,548.13 |
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 $239.88 Median $295.12 Typical High $446.68 | Professional | None | $239.88 | $295.12 | $446.68 |
Kaiser Permanente Setting Professional Modifier None Typical Low $204.17 Median $239.88 Typical High $302.00 | Professional | None | $204.17 | $239.88 | $302.00 |
Medcost Setting Professional Modifier None Typical Low $363.08 Median $457.09 Typical High $457.09 | Professional | None | $363.08 | $457.09 | $457.09 |
Medcost Setting Facility Modifier None Typical Low $281.84 Median $346.74 Typical High $457.09 | Facility | None | $281.84 | $346.74 | $457.09 |
Medcost Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $323.59 | Professional | None | $323.59 | $323.59 | $323.59 |
Sentara Setting Facility Modifier None Typical Low $257.04 Median $1,122.02 Typical High $8,709.64 | Facility | None | $257.04 | $1,122.02 | $8,709.64 |
Sentara Setting Professional Modifier None Typical Low $251.19 Median $331.13 Typical High $4,073.80 | Professional | None | $251.19 | $331.13 | $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 $204.17 Median $331.13 Typical High $501.19 | Professional | None | $204.17 | $331.13 | $501.19 |
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 $134.90 Median $141.25 Typical High $144.54 | Professional | 52 · Reduced service | $134.90 | $141.25 | $144.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $56.23 Typical High $58.88 | Professional | 53 · Discontinued | $53.70 | $56.23 | $58.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $199.53 Median $208.93 Typical High $218.78 | Professional | 54 · Surgery only | $199.53 | $208.93 | $218.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $41.69 Typical High $43.65 | Professional | 55 · Aftercare only | $39.81 | $41.69 | $43.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $28.18 Typical High $29.51 | Professional | 56 · Pre-op care only | $26.92 | $28.18 | $29.51 |
Where Virginia sits
The same service costs 8.5 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 $6,252MT $735
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.