How much rates vary
Facilitymedian $1,413 · 10th to 90th $186 to $5,754Professionalmedian $245 · 10th to 90th $132 to $427
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 $186.21 Median $562.34 Typical High $8,317.64 | Facility | None | $186.21 | $562.34 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $151.36 Median $275.42 Typical High $575.44 | Professional | None | $151.36 | $275.42 | $575.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,884.03 Median $3,715.35 Typical High $4,265.80 | Facility | None | $2,884.03 | $3,715.35 | $4,265.80 |
Anthem BCBS Setting Professional Modifier None Typical Low $128.82 Median $223.87 Typical High $331.13 | Professional | None | $128.82 | $223.87 | $331.13 |
CareFirst Setting Professional Modifier None Typical Low $138.04 Median $154.88 Typical High $2,511.89 | Professional | None | $138.04 | $154.88 | $2,511.89 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $954.99 Typical High $2,187.76 | Facility | None | $478.63 | $954.99 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $131.83 Median $251.19 Typical High $426.58 | Professional | None | $131.83 | $251.19 | $426.58 |
Kaiser Permanente Setting Professional Modifier None Typical Low $117.49 Median $338.84 Typical High $416.87 | Professional | None | $117.49 | $338.84 | $416.87 |
Medcost Setting Professional Modifier None Typical Low $407.38 Median $512.86 Typical High $512.86 | Professional | None | $407.38 | $512.86 | $512.86 |
Medcost Setting Facility Modifier None Typical Low $151.36 Median $245.47 Typical High $457.09 | Facility | None | $151.36 | $245.47 | $457.09 |
Medcost Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $398.11 | Professional | None | $398.11 | $398.11 | $398.11 |
Sentara Setting Facility Modifier None Typical Low $141.25 Median $912.01 Typical High $3,630.78 | Facility | None | $141.25 | $912.01 | $3,630.78 |
Sentara Setting Professional Modifier None Typical Low $245.47 Median $363.08 Typical High $2,137.96 | Professional | None | $245.47 | $363.08 | $2,137.96 |
United Setting Facility Modifier None Typical Low $588.84 Median $2,187.76 Typical High $5,888.44 | Facility | None | $588.84 | $2,187.76 | $5,888.44 |
United Setting Professional Modifier None Typical Low $120.23 Median $245.47 Typical High $489.78 | Professional | None | $120.23 | $245.47 | $489.78 |
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 $75.86 Median $109.65 Typical High $154.88 | Professional | 52 · Reduced service | $75.86 | $109.65 | $154.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $43.65 Typical High $61.66 | Professional | 53 · Discontinued | $30.20 | $43.65 | $61.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $162.18 Typical High $234.42 | Professional | 54 · Surgery only | $114.82 | $162.18 | $234.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $32.36 Typical High $46.77 | Professional | 55 · Aftercare only | $22.91 | $32.36 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $21.88 Typical High $30.90 | Professional | 56 · Pre-op care only | $15.14 | $21.88 | $30.90 |
Where Virginia sits
The same service costs 8.2 times more in Colorado than in West Virginia. 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 $4,192WV $514
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.