How much rates vary
Facilitymedian $1,950 · 10th to 90th $151 to $5,754Professionalmedian $182 · 10th to 90th $117 to $275
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 $218.78 Median $3,981.07 Typical High $9,332.54 | Facility | None | $218.78 | $3,981.07 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $128.82 Median $213.80 Typical High $269.15 | Professional | None | $128.82 | $213.80 | $269.15 |
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 $120.23 Median $194.98 Typical High $263.03 | Professional | None | $120.23 | $194.98 | $263.03 |
CareFirst Setting Professional Modifier None Typical Low $117.49 Median $131.83 Typical High $154.88 | Professional | None | $117.49 | $131.83 | $154.88 |
Cigna Setting Facility Modifier None Typical Low $346.74 Median $1,479.11 Typical High $2,818.38 | Facility | None | $346.74 | $1,479.11 | $2,818.38 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $190.55 Typical High $269.15 | Professional | None | $120.23 | $190.55 | $269.15 |
Kaiser Permanente Setting Professional Modifier None Typical Low $208.93 Median $245.47 Typical High $338.84 | Professional | None | $208.93 | $245.47 | $338.84 |
Medcost Setting Professional Modifier None Typical Low $234.42 Median $295.12 Typical High $295.12 | Professional | None | $234.42 | $295.12 | $295.12 |
Medcost Setting Facility Modifier None Typical Low $128.82 Median $208.93 Typical High $363.08 | Facility | None | $128.82 | $208.93 | $363.08 |
Medcost Setting Professional Modifier None Typical Low $117.49 Median $138.04 Typical High $263.03 | Professional | None | $117.49 | $138.04 | $263.03 |
Sentara Setting Facility Modifier None Typical Low $112.20 Median $912.01 Typical High $3,981.07 | Facility | None | $112.20 | $912.01 | $3,981.07 |
Sentara Setting Professional Modifier None Typical Low $204.17 Median $223.87 Typical High $346.74 | Professional | None | $204.17 | $223.87 | $346.74 |
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 $93.33 Median $162.18 Typical High $295.12 | Professional | None | $93.33 | $162.18 | $295.12 |
6 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 $64.57 Median $83.18 Typical High $134.90 | Professional | 52 · Reduced service | $64.57 | $83.18 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $33.11 Typical High $53.70 | Professional | 53 · Discontinued | $25.70 | $33.11 | $53.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $95.50 Median $123.03 Typical High $199.53 | Professional | 54 · Surgery only | $95.50 | $123.03 | $199.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $24.55 Typical High $39.81 | Professional | 55 · Aftercare only | $19.05 | $24.55 | $39.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $16.60 Typical High $26.92 | Professional | 56 · Pre-op care only | $12.88 | $16.60 | $26.92 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $89.13 Median $114.82 Typical High $186.21 | Professional | 78 · Unplanned return to OR | $89.13 | $114.82 | $186.21 |
Where Virginia sits
The same service costs 9.8 times more in Colorado than in North Dakota. 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 $4,589ND $469
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.