How much rates vary
Facilitymedian $2,089 · 10th to 90th $355 to $6,607Professionalmedian $355 · 10th to 90th $282 to $589
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 $380.19 Median $5,495.41 Typical High $14,125.38 | Facility | None | $380.19 | $5,495.41 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $354.81 Median $380.19 Typical High $724.44 | Professional | None | $354.81 | $380.19 | $724.44 |
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 $281.84 Median $338.84 Typical High $426.58 | Professional | None | $281.84 | $338.84 | $426.58 |
CareFirst Setting Professional Modifier None Typical Low $302.00 Median $331.13 Typical High $416.87 | Professional | None | $302.00 | $331.13 | $416.87 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $794.33 Typical High $5,495.41 | Facility | None | $501.19 | $794.33 | $5,495.41 |
Cigna Setting Professional Modifier None Typical Low $281.84 Median $389.05 Typical High $549.54 | Professional | None | $281.84 | $389.05 | $549.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $269.15 Median $316.23 Typical High $398.11 | Professional | None | $269.15 | $316.23 | $398.11 |
Medcost Setting Facility Modifier None Typical Low $354.81 Median $416.87 Typical High $575.44 | Facility | None | $354.81 | $416.87 | $575.44 |
Medcost Setting Professional Modifier None Typical Low $426.58 Median $426.58 Typical High $426.58 | Professional | None | $426.58 | $426.58 | $426.58 |
Sentara Setting Facility Modifier None Typical Low $316.23 Median $831.76 Typical High $5,128.61 | Facility | None | $316.23 | $831.76 | $5,128.61 |
Sentara Setting Professional Modifier None Typical Low $316.23 Median $416.87 Typical High $2,187.76 | Professional | None | $316.23 | $416.87 | $2,187.76 |
United Setting Facility Modifier None Typical Low $436.52 Median $2,344.23 Typical High $6,309.57 | Facility | None | $436.52 | $2,344.23 | $6,309.57 |
United Setting Professional Modifier None Typical Low $275.42 Median $457.09 Typical High $691.83 | Professional | None | $275.42 | $457.09 | $691.83 |
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 $173.78 Median $173.78 Typical High $190.55 | Professional | 52 · Reduced service | $173.78 | $173.78 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $70.79 Typical High $75.86 | Professional | 53 · Discontinued | $70.79 | $70.79 | $75.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $263.03 Typical High $281.84 | Professional | 54 · Surgery only | $263.03 | $263.03 | $281.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $52.48 Typical High $56.23 | Professional | 55 · Aftercare only | $52.48 | $52.48 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $35.48 Typical High $38.02 | Professional | 56 · Pre-op care only | $35.48 | $35.48 | $38.02 |
Where Virginia sits
The same service costs 6.1 times more in Alaska than in Maryland. 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
AK $5,496MD $901
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.