How much rates vary
Facilitymedian $11,220 · 10th to 90th $617 to $43,652Professionalmedian $4,898 · 10th to 90th $501 to $9,550
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 $2,454.71 Median $7,244.36 Typical High $15,488.17 | Facility | None | $2,454.71 | $7,244.36 | $15,488.17 |
Aetna Setting Professional Modifier None Typical Low $588.84 Median $5,623.41 Typical High $7,585.78 | Professional | None | $588.84 | $5,623.41 | $7,585.78 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,309.57 Median $8,709.64 Typical High $11,481.54 | Facility | None | $6,309.57 | $8,709.64 | $11,481.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $489.78 Median $1,737.80 Typical High $6,760.83 | Professional | None | $489.78 | $1,737.80 | $6,760.83 |
CareFirst Setting Professional Modifier None Typical Low $478.63 Median $524.81 Typical High $19,952.62 | Professional | None | $478.63 | $524.81 | $19,952.62 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $12,302.69 Typical High $23,442.29 | Facility | None | $512.86 | $12,302.69 | $23,442.29 |
Cigna Setting Professional Modifier None Typical Low $501.19 Median $1,412.54 Typical High $9,772.37 | Professional | None | $501.19 | $1,412.54 | $9,772.37 |
Kaiser Permanente Setting Professional Modifier None Typical Low $426.58 Median $6,918.31 Typical High $8,709.64 | Professional | None | $426.58 | $6,918.31 | $8,709.64 |
Medcost Setting Facility Modifier None Typical Low $588.84 Median $954.99 Typical High $12,022.64 | Facility | None | $588.84 | $954.99 | $12,022.64 |
Medcost Setting Professional Modifier None Typical Low $8,912.51 Median $8,912.51 Typical High $8,912.51 | Professional | None | $8,912.51 | $8,912.51 | $8,912.51 |
Sentara Setting Facility Modifier None Typical Low $512.86 Median $2,454.71 Typical High $40,738.03 | Facility | None | $512.86 | $2,454.71 | $40,738.03 |
Sentara Setting Professional Modifier None Typical Low $6,165.95 Median $8,709.64 Typical High $25,703.96 | Professional | None | $6,165.95 | $8,709.64 | $25,703.96 |
United Setting Facility Modifier None Typical Low $8,912.51 Median $19,952.62 Typical High $64,565.42 | Facility | None | $8,912.51 | $19,952.62 | $64,565.42 |
United Setting Professional Modifier None Typical Low $512.86 Median $1,548.82 Typical High $11,481.54 | Professional | None | $512.86 | $1,548.82 | $11,481.54 |
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 $295.12 Median $562.34 Typical High $3,715.35 | Professional | 52 · Reduced service | $295.12 | $562.34 | $3,715.35 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $117.49 Median $229.09 Typical High $1,479.11 | Professional | 53 · Discontinued | $117.49 | $229.09 | $1,479.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $851.14 Typical High $5,495.41 | Professional | 54 · Surgery only | $436.52 | $851.14 | $5,495.41 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $169.82 Typical High $1,122.02 | Professional | 55 · Aftercare only | $87.10 | $169.82 | $1,122.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $112.20 Typical High $741.31 | Professional | 56 · Pre-op care only | $58.88 | $112.20 | $741.31 |
Where Virginia sits
The same service costs 6.1 times more in Alaska than in Vermont. 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 $33,081VT $5,424
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.