How much rates vary
Facilitymedian $7,586 · 10th to 90th $525 to $21,878Professionalmedian $4,169 · 10th to 90th $417 to $7,244
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 $616.60 Median $5,370.32 Typical High $10,715.19 | Facility | None | $616.60 | $5,370.32 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $501.19 Median $4,365.16 Typical High $7,079.46 | Professional | None | $501.19 | $4,365.16 | $7,079.46 |
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 $407.38 Median $1,445.44 Typical High $5,754.40 | Professional | None | $407.38 | $1,445.44 | $5,754.40 |
CareFirst Setting Professional Modifier None Typical Low $398.11 Median $436.52 Typical High $15,488.17 | Professional | None | $398.11 | $436.52 | $15,488.17 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $6,456.54 Typical High $12,882.50 | Facility | None | $512.86 | $6,456.54 | $12,882.50 |
Cigna Setting Professional Modifier None Typical Low $407.38 Median $1,230.27 Typical High $7,079.46 | Professional | None | $407.38 | $1,230.27 | $7,079.46 |
Kaiser Permanente Setting Professional Modifier None Typical Low $354.81 Median $5,128.61 Typical High $6,456.54 | Professional | None | $354.81 | $5,128.61 | $6,456.54 |
Medcost Setting Facility Modifier None Typical Low $501.19 Median $812.83 Typical High $8,709.64 | Facility | None | $501.19 | $812.83 | $8,709.64 |
Medcost Setting Professional Modifier None Typical Low $6,025.60 Median $6,025.60 Typical High $6,025.60 | Professional | None | $6,025.60 | $6,025.60 | $6,025.60 |
Sentara Setting Facility Modifier None Typical Low $446.68 Median $2,290.87 Typical High $21,379.62 | Facility | None | $446.68 | $2,290.87 | $21,379.62 |
Sentara Setting Professional Modifier None Typical Low $4,570.88 Median $6,456.54 Typical High $17,378.01 | Professional | None | $4,570.88 | $6,456.54 | $17,378.01 |
United Setting Facility Modifier None Typical Low $4,570.88 Median $12,882.50 Typical High $36,307.81 | Facility | None | $4,570.88 | $12,882.50 | $36,307.81 |
United Setting Professional Modifier None Typical Low $436.52 Median $1,318.26 Typical High $8,912.51 | Professional | None | $436.52 | $1,318.26 | $8,912.51 |
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 $251.19 Median $478.63 Typical High $3,162.28 | Professional | 52 · Reduced service | $251.19 | $478.63 | $3,162.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $190.55 Typical High $1,288.25 | Professional | 53 · Discontinued | $100.00 | $190.55 | $1,288.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $707.95 Typical High $4,786.30 | Professional | 54 · Surgery only | $380.19 | $707.95 | $4,786.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $141.25 Typical High $954.99 | Professional | 55 · Aftercare only | $75.86 | $141.25 | $954.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $95.50 Typical High $630.96 | Professional | 56 · Pre-op care only | $50.12 | $95.50 | $630.96 |
Where Virginia sits
The same service costs 4.3 times more in Alabama than in Maine. 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 $20,420ME $4,758
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.