How much rates vary
Facilitymedian $3,020 · 10th to 90th $269 to $12,023Professionalmedian $692 · 10th to 90th $182 to $1,288
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 $316.23 Median $1,819.70 Typical High $8,317.64 | Facility | None | $316.23 | $1,819.70 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $208.93 Median $831.76 Typical High $1,778.28 | Professional | None | $208.93 | $831.76 | $1,778.28 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,754.40 Median $8,317.64 Typical High $11,481.54 | Facility | None | $5,754.40 | $8,317.64 | $11,481.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $177.83 Median $446.68 Typical High $977.24 | Professional | None | $177.83 | $446.68 | $977.24 |
CareFirst Setting Professional Modifier None Typical Low $173.78 Median $194.98 Typical High $3,019.95 | Professional | None | $173.78 | $194.98 | $3,019.95 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $2,089.30 Typical High $3,890.45 | Facility | None | $478.63 | $2,089.30 | $3,890.45 |
Cigna Setting Professional Modifier None Typical Low $181.97 Median $501.19 Typical High $1,174.90 | Professional | None | $181.97 | $501.19 | $1,174.90 |
Kaiser Permanente Setting Professional Modifier None Typical Low $158.49 Median $891.25 Typical High $1,096.48 | Professional | None | $158.49 | $891.25 | $1,096.48 |
Medcost Setting Professional Modifier None Typical Low $912.01 Median $1,288.25 Typical High $1,288.25 | Professional | None | $912.01 | $1,288.25 | $1,288.25 |
Medcost Setting Facility Modifier None Typical Low $208.93 Median $338.84 Typical High $1,380.38 | Facility | None | $208.93 | $338.84 | $1,380.38 |
Medcost Setting Professional Modifier None Typical Low $954.99 Median $954.99 Typical High $954.99 | Professional | None | $954.99 | $954.99 | $954.99 |
Sentara Setting Facility Modifier None Typical Low $194.98 Median $1,023.29 Typical High $10,232.93 | Facility | None | $194.98 | $1,023.29 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $676.08 Median $1,071.52 Typical High $10,000.00 | Professional | None | $676.08 | $1,071.52 | $10,000.00 |
United Setting Facility Modifier None Typical Low $1,548.82 Median $6,760.83 Typical High $17,378.01 | Facility | None | $1,548.82 | $6,760.83 | $17,378.01 |
United Setting Professional Modifier None Typical Low $181.97 Median $537.03 Typical High $1,445.44 | Professional | None | $181.97 | $537.03 | $1,445.44 |
6 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 $104.71 Median $204.17 Typical High $524.81 | Professional | 52 · Reduced service | $104.71 | $204.17 | $524.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $81.28 Typical High $208.93 | Professional | 53 · Discontinued | $41.69 | $81.28 | $208.93 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $154.88 Median $302.00 Typical High $794.33 | Professional | 54 · Surgery only | $154.88 | $302.00 | $794.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $60.26 Typical High $158.49 | Professional | 55 · Aftercare only | $30.90 | $60.26 | $158.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $40.74 Typical High $104.71 | Professional | 56 · Pre-op care only | $20.89 | $40.74 | $104.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $144.54 Median $281.84 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $144.54 | $281.84 | $741.31 |
Where Virginia sits
The same service costs 5.1 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 $7,315MT $1,443
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.