How much rates vary
Facilitymedian $832 · 10th to 90th $141 to $5,495Professionalmedian $537 · 10th to 90th $141 to $1,047
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 $794.33 Median $4,073.80 Typical High $14,125.38 | Facility | None | $794.33 | $4,073.80 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $165.96 Median $741.31 Typical High $1,445.44 | Professional | None | $165.96 | $741.31 | $1,445.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $141.25 Median $338.84 Typical High $741.31 | Professional | None | $141.25 | $338.84 | $741.31 |
CareFirst Setting Professional Modifier None Typical Low $144.54 Median $158.49 Typical High $912.01 | Professional | None | $144.54 | $158.49 | $912.01 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $1,230.27 Typical High $3,019.95 | Facility | None | $512.86 | $1,230.27 | $3,019.95 |
Cigna Setting Professional Modifier None Typical Low $144.54 Median $407.38 Typical High $1,047.13 | Professional | None | $144.54 | $407.38 | $1,047.13 |
Kaiser Permanente Setting Professional Modifier None Typical Low $123.03 Median $676.08 Typical High $831.76 | Professional | None | $123.03 | $676.08 | $831.76 |
Medcost Setting Facility Modifier None Typical Low $165.96 Median $275.42 Typical High $1,318.26 | Facility | None | $165.96 | $275.42 | $1,318.26 |
Medcost Setting Professional Modifier None Typical Low $977.24 Median $977.24 Typical High $977.24 | Professional | None | $977.24 | $977.24 | $977.24 |
Sentara Setting Facility Modifier None Typical Low $125.89 Median $371.54 Typical High $2,454.71 | Facility | None | $125.89 | $371.54 | $2,454.71 |
Sentara Setting Professional Modifier None Typical Low $676.08 Median $954.99 Typical High $1,862.09 | Professional | None | $676.08 | $954.99 | $1,862.09 |
United Setting Facility Modifier None Typical Low $100.00 Median $660.69 Typical High $2,089.30 | Facility | None | $100.00 | $660.69 | $2,089.30 |
United Setting Professional Modifier None Typical Low $134.90 Median $436.52 Typical High $1,230.27 | Professional | None | $134.90 | $436.52 | $1,230.27 |
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 $83.18 Median $162.18 Typical High $398.11 | Professional | 52 · Reduced service | $83.18 | $162.18 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $64.57 Typical High $158.49 | Professional | 53 · Discontinued | $33.11 | $64.57 | $158.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $125.89 Median $245.47 Typical High $602.56 | Professional | 54 · Surgery only | $125.89 | $245.47 | $602.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $48.98 Typical High $120.23 | Professional | 55 · Aftercare only | $25.12 | $48.98 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $32.36 Typical High $79.43 | Professional | 56 · Pre-op care only | $16.60 | $32.36 | $79.43 |
Where Virginia sits
The same service costs 17.4 times more in Alabama 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
AL $9,157MT $526
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.