How much rates vary
Facilitymedian $2,138 · 10th to 90th $275 to $6,607Professionalmedian $275 · 10th to 90th $219 to $447
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 $288.40 Median $5,495.41 Typical High $14,125.38 | Facility | None | $288.40 | $5,495.41 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $269.15 Median $288.40 Typical High $562.34 | Professional | None | $269.15 | $288.40 | $562.34 |
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 $218.78 Median $257.04 Typical High $331.13 | Professional | None | $218.78 | $257.04 | $331.13 |
CareFirst Setting Professional Modifier None Typical Low $229.09 Median $257.04 Typical High $316.23 | Professional | None | $229.09 | $257.04 | $316.23 |
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 $218.78 Median $302.00 Typical High $416.87 | Professional | None | $218.78 | $302.00 | $416.87 |
Kaiser Permanente Setting Professional Modifier None Typical Low $204.17 Median $245.47 Typical High $302.00 | Professional | None | $204.17 | $245.47 | $302.00 |
Medcost Setting Facility Modifier None Typical Low $269.15 Median $323.59 Typical High $436.52 | Facility | None | $269.15 | $323.59 | $436.52 |
Medcost Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $331.13 | Professional | None | $331.13 | $331.13 | $331.13 |
Sentara Setting Facility Modifier None Typical Low $234.42 Median $912.01 Typical High $5,128.61 | Facility | None | $234.42 | $912.01 | $5,128.61 |
Sentara Setting Professional Modifier None Typical Low $239.88 Median $323.59 Typical High $2,187.76 | Professional | None | $239.88 | $323.59 | $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 $213.80 Median $346.74 Typical High $524.81 | Professional | None | $213.80 | $346.74 | $524.81 |
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 $134.90 Typical High $144.54 | Professional | 52 · Reduced service | $134.90 | $134.90 | $144.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $53.70 Typical High $57.54 | Professional | 53 · Discontinued | $53.70 | $53.70 | $57.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $204.17 Typical High $218.78 | Professional | 54 · Surgery only | $204.17 | $204.17 | $218.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $40.74 Typical High $43.65 | Professional | 55 · Aftercare only | $40.74 | $40.74 | $43.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $26.92 Typical High $28.84 | Professional | 56 · Pre-op care only | $26.92 | $26.92 | $28.84 |
Where Virginia sits
The same service costs 7.3 times more in Alaska 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
AK $5,199MT $710
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.