How much rates vary
Facilitymedian $2,138 · 10th to 90th $562 to $6,166Professionalmedian $550 · 10th to 90th $468 to $708
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 $602.56 Median $5,370.32 Typical High $14,125.38 | Facility | None | $602.56 | $5,370.32 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $575.44 Median $575.44 Typical High $602.56 | Professional | None | $575.44 | $575.44 | $602.56 |
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 $478.63 Median $575.44 Typical High $676.08 | Professional | None | $478.63 | $575.44 | $676.08 |
CareFirst Setting Professional Modifier None Typical Low $478.63 Median $524.81 Typical High $630.96 | Professional | None | $478.63 | $524.81 | $630.96 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $1,513.56 Typical High $2,818.38 | Facility | None | $524.81 | $1,513.56 | $2,818.38 |
Cigna Setting Professional Modifier None Typical Low $489.78 Median $537.03 Typical High $758.58 | Professional | None | $489.78 | $537.03 | $758.58 |
Kaiser Permanente Setting Professional Modifier None Typical Low $426.58 Median $489.78 Typical High $831.76 | Professional | None | $426.58 | $489.78 | $831.76 |
Medcost Setting Professional Modifier None Typical Low $676.08 Median $851.14 Typical High $851.14 | Professional | None | $676.08 | $851.14 | $851.14 |
Medcost Setting Facility Modifier None Typical Low $575.44 Median $676.08 Typical High $933.25 | Facility | None | $575.44 | $676.08 | $933.25 |
Medcost Setting Professional Modifier None Typical Low $478.63 Median $602.56 Typical High $676.08 | Professional | None | $478.63 | $602.56 | $676.08 |
Sentara Setting Facility Modifier None Typical Low $489.78 Median $1,071.52 Typical High $3,981.07 | Facility | None | $489.78 | $1,071.52 | $3,981.07 |
Sentara Setting Professional Modifier None Typical Low $512.86 Median $575.44 Typical High $851.14 | Professional | None | $512.86 | $575.44 | $851.14 |
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 $398.11 Median $489.78 Typical High $870.96 | Professional | None | $398.11 | $489.78 | $870.96 |
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 $288.40 Median $288.40 Typical High $302.00 | Professional | 52 · Reduced service | $288.40 | $288.40 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $114.82 Typical High $120.23 | Professional | 53 · Discontinued | $114.82 | $114.82 | $120.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $426.58 Typical High $446.68 | Professional | 54 · Surgery only | $426.58 | $426.58 | $446.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $85.11 Typical High $89.13 | Professional | 55 · Aftercare only | $85.11 | $85.11 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $57.54 Typical High $60.26 | Professional | 56 · Pre-op care only | $57.54 | $57.54 | $60.26 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $398.11 Typical High $416.87 | Professional | 78 · Unplanned return to OR | $398.11 | $398.11 | $416.87 |
Where Virginia sits
The same service costs 3.9 times more in Colorado than in Delaware. 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 $5,057DE $1,284
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.