How much rates vary
Facilitymedian $3,981 · 10th to 90th $263 to $12,882Professionalmedian $550 · 10th to 90th $178 to $1,000
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 $676.08 Median $5,495.41 Typical High $14,125.38 | Facility | None | $676.08 | $5,495.41 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $208.93 Median $676.08 Typical High $1,584.89 | Professional | None | $208.93 | $676.08 | $1,584.89 |
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 $173.78 Median $457.09 Typical High $741.31 | Professional | None | $173.78 | $457.09 | $741.31 |
CareFirst Setting Professional Modifier None Typical Low $169.82 Median $190.55 Typical High $3,715.35 | Professional | None | $169.82 | $190.55 | $3,715.35 |
Cigna Setting Facility Modifier None Typical Low $346.74 Median $549.54 Typical High $1,621.81 | Facility | None | $346.74 | $549.54 | $1,621.81 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $489.78 Typical High $954.99 | Professional | None | $177.83 | $489.78 | $954.99 |
Kaiser Permanente Setting Professional Modifier None Typical Low $151.36 Median $676.08 Typical High $851.14 | Professional | None | $151.36 | $676.08 | $851.14 |
Medcost Setting Professional Modifier None Typical Low $954.99 Median $1,174.90 Typical High $1,230.27 | Professional | None | $954.99 | $1,174.90 | $1,230.27 |
Medcost Setting Facility Modifier None Typical Low $208.93 Median $338.84 Typical High $1,096.48 | Facility | None | $208.93 | $338.84 | $1,096.48 |
Medcost Setting Professional Modifier None Typical Low $741.31 Median $741.31 Typical High $741.31 | Professional | None | $741.31 | $741.31 | $741.31 |
Sentara Setting Facility Modifier None Typical Low $190.55 Median $1,023.29 Typical High $10,232.93 | Facility | None | $190.55 | $1,023.29 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $630.96 Median $933.25 Typical High $10,000.00 | Professional | None | $630.96 | $933.25 | $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 $457.09 Typical High $1,174.90 | Professional | None | $181.97 | $457.09 | $1,174.90 |
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 $104.71 Median $199.53 Typical High $398.11 | Professional | 52 · Reduced service | $104.71 | $199.53 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $81.28 Typical High $158.49 | Professional | 53 · Discontinued | $41.69 | $81.28 | $158.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $154.88 Median $302.00 Typical High $588.84 | Professional | 54 · Surgery only | $154.88 | $302.00 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $60.26 Typical High $120.23 | Professional | 55 · Aftercare only | $30.90 | $60.26 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $40.74 Typical High $79.43 | Professional | 56 · Pre-op care only | $20.89 | $40.74 | $79.43 |
Where Virginia sits
The same service costs 6.9 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 $7,377MT $1,063
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.