How much rates vary
Facilitymedian $1,862 · 10th to 90th $263 to $6,166Professionalmedian $224 · 10th to 90th $182 to $407
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 $229.09 Median $4,073.80 Typical High $10,000.00 | Facility | None | $229.09 | $4,073.80 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $223.87 Median $229.09 Typical High $467.74 | Professional | None | $223.87 | $229.09 | $467.74 |
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 $181.97 Median $218.78 Typical High $257.04 | Professional | None | $181.97 | $218.78 | $257.04 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $114.82 Median $138.04 Typical High $162.18 | Professional | 62 · Two surgeons | $114.82 | $138.04 | $162.18 |
CareFirst Setting Professional Modifier None Typical Low $190.55 Median $208.93 Typical High $245.47 | Professional | None | $190.55 | $208.93 | $245.47 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $1,000.00 Typical High $2,187.76 | Facility | None | $478.63 | $1,000.00 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $190.55 Median $199.53 Typical High $446.68 | Professional | None | $190.55 | $199.53 | $446.68 |
Kaiser Permanente Setting Professional Modifier None Typical Low $173.78 Median $194.98 Typical High $416.87 | Professional | None | $173.78 | $194.98 | $416.87 |
Medcost Setting Professional Modifier None Typical Low $338.84 Median $426.58 Typical High $436.52 | Professional | None | $338.84 | $426.58 | $436.52 |
Medcost Setting Facility Modifier None Typical Low $229.09 Median $363.08 Typical High $758.58 | Facility | None | $229.09 | $363.08 | $758.58 |
Medcost Setting Professional Modifier None Typical Low $302.00 Median $331.13 Typical High $338.84 | Professional | None | $302.00 | $331.13 | $338.84 |
Sentara Setting Facility Modifier None Typical Low $213.80 Median $1,023.29 Typical High $3,630.78 | Facility | None | $213.80 | $1,023.29 | $3,630.78 |
Sentara Setting Professional Modifier None Typical Low $204.17 Median $309.03 Typical High $562.34 | Professional | None | $204.17 | $309.03 | $562.34 |
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 $165.96 Median $223.87 Typical High $436.52 | Professional | None | $165.96 | $223.87 | $436.52 |
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 $112.20 Median $114.82 Typical High $234.42 | Professional | 52 · Reduced service | $112.20 | $114.82 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $45.71 Typical High $93.33 | Professional | 53 · Discontinued | $44.67 | $45.71 | $93.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $165.96 Median $169.82 Typical High $346.74 | Professional | 54 · Surgery only | $165.96 | $169.82 | $346.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $33.88 Typical High $69.18 | Professional | 55 · Aftercare only | $33.88 | $33.88 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $22.91 Typical High $46.77 | Professional | 56 · Pre-op care only | $22.39 | $22.91 | $46.77 |
Where Virginia sits
The same service costs 6.8 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 $4,179MT $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.