How much rates vary
Facilitymedian $2,138 · 10th to 90th $295 to $7,413Professionalmedian $234 · 10th to 90th $191 to $417
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 $234.42 Median $7,079.46 Typical High $14,125.38 | Facility | None | $234.42 | $7,079.46 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $204.17 Median $234.42 Typical High $4,168.69 | Professional | None | $204.17 | $234.42 | $4,168.69 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,884.03 Median $3,715.35 Typical High $4,265.80 | Facility | None | $2,884.03 | $3,715.35 | $4,265.80 |
Anthem BCBS Setting Professional Modifier None Typical Low $190.55 Median $223.87 Typical High $288.40 | Professional | None | $190.55 | $223.87 | $288.40 |
CareFirst Setting Professional Modifier None Typical Low $186.21 Median $208.93 Typical High $2,511.89 | Professional | None | $186.21 | $208.93 | $2,511.89 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $1,000.00 Typical High $2,691.53 | Facility | None | $512.86 | $1,000.00 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $194.98 Median $239.88 Typical High $457.09 | Professional | None | $194.98 | $239.88 | $457.09 |
Kaiser Permanente Setting Professional Modifier None Typical Low $165.96 Median $199.53 Typical High $245.47 | Professional | None | $165.96 | $199.53 | $245.47 |
Medcost Setting Professional Modifier None Typical Low $416.87 Median $524.81 Typical High $524.81 | Professional | None | $416.87 | $524.81 | $524.81 |
Medcost Setting Facility Modifier None Typical Low $234.42 Median $380.19 Typical High $436.52 | Facility | None | $234.42 | $380.19 | $436.52 |
Medcost Setting Professional Modifier None Typical Low $416.87 Median $416.87 Typical High $416.87 | Professional | None | $416.87 | $416.87 | $416.87 |
Sentara Setting Facility Modifier None Typical Low $213.80 Median $933.25 Typical High $7,079.46 | Facility | None | $213.80 | $933.25 | $7,079.46 |
Sentara Setting Professional Modifier None Typical Low $208.93 Median $295.12 Typical High $2,137.96 | Professional | None | $208.93 | $295.12 | $2,137.96 |
United Setting Facility Modifier None Typical Low $588.84 Median $2,187.76 Typical High $5,888.44 | Facility | None | $588.84 | $2,187.76 | $5,888.44 |
United Setting Professional Modifier None Typical Low $169.82 Median $295.12 Typical High $467.74 | Professional | None | $169.82 | $295.12 | $467.74 |
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 $102.33 Median $117.49 Typical High $117.49 | Professional | 52 · Reduced service | $102.33 | $117.49 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $46.77 Typical High $46.77 | Professional | 53 · Discontinued | $40.74 | $46.77 | $46.77 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $151.36 Median $173.78 Typical High $173.78 | Professional | 54 · Surgery only | $151.36 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $34.67 Typical High $34.67 | Professional | 55 · Aftercare only | $30.90 | $34.67 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $23.44 Typical High $23.44 | Professional | 56 · Pre-op care only | $20.42 | $23.44 | $23.44 |
Where Virginia sits
The same service costs 7.6 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 $4,681MT $618
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.