How much rates vary
Facilitymedian $1,698 · 10th to 90th $174 to $5,754Professionalmedian $200 · 10th to 90th $126 to $479
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 $147.91 Median $2,818.38 Typical High $10,000.00 | Facility | None | $147.91 | $2,818.38 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $147.91 Median $363.08 Typical High $478.63 | Professional | None | $147.91 | $363.08 | $478.63 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,000.00 Median $3,630.78 Typical High $4,168.69 | Facility | None | $1,000.00 | $3,630.78 | $4,168.69 |
Anthem BCBS Setting Professional Modifier None Typical Low $123.03 Median $295.12 Typical High $467.74 | Professional | None | $123.03 | $295.12 | $467.74 |
CareFirst Setting Professional Modifier None Typical Low $125.89 Median $141.25 Typical High $165.96 | Professional | None | $125.89 | $141.25 | $165.96 |
Cigna Setting Facility Modifier None Typical Low $346.74 Median $912.01 Typical High $1,737.80 | Facility | None | $346.74 | $912.01 | $1,737.80 |
Cigna Setting Professional Modifier None Typical Low $128.82 Median $218.78 Typical High $426.58 | Professional | None | $128.82 | $218.78 | $426.58 |
Kaiser Permanente Setting Professional Modifier None Typical Low $407.38 Median $478.63 Typical High $602.56 | Professional | None | $407.38 | $478.63 | $602.56 |
Medcost Setting Professional Modifier None Typical Low $181.97 Median $229.09 Typical High $275.42 | Professional | None | $181.97 | $229.09 | $275.42 |
Medcost Setting Facility Modifier None Typical Low $147.91 Median $194.98 Typical High $616.60 | Facility | None | $147.91 | $194.98 | $616.60 |
Medcost Setting Professional Modifier None Typical Low $173.78 Median $181.97 Typical High $363.08 | Professional | None | $173.78 | $181.97 | $363.08 |
Sentara Setting Facility Modifier None Typical Low $128.82 Median $912.01 Typical High $3,630.78 | Facility | None | $128.82 | $912.01 | $3,630.78 |
Sentara Setting Professional Modifier None Typical Low $141.25 Median $398.11 Typical High $616.60 | Professional | None | $141.25 | $398.11 | $616.60 |
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 $107.15 Median $194.98 Typical High $478.63 | Professional | None | $107.15 | $194.98 | $478.63 |
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 $74.13 Median $91.20 Typical High $239.88 | Professional | 52 · Reduced service | $74.13 | $91.20 | $239.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $29.51 Median $36.31 Typical High $95.50 | Professional | 53 · Discontinued | $29.51 | $36.31 | $95.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $112.20 Median $138.04 Typical High $354.81 | Professional | 54 · Surgery only | $112.20 | $138.04 | $354.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $27.54 Typical High $70.79 | Professional | 55 · Aftercare only | $22.39 | $27.54 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.79 Median $18.20 Typical High $47.86 | Professional | 56 · Pre-op care only | $14.79 | $18.20 | $47.86 |
Where Virginia sits
The same service costs 5.7 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 $4,090MT $722
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.