How much rates vary
Facilitymedian $1,862 · 10th to 90th $229 to $6,026Professionalmedian $263 · 10th to 90th $162 to $550
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 $194.98 Median $4,073.80 Typical High $10,000.00 | Facility | None | $194.98 | $4,073.80 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $194.98 Median $338.84 Typical High $549.54 | Professional | None | $194.98 | $338.84 | $549.54 |
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 $162.18 Median $354.81 Typical High $549.54 | Professional | None | $162.18 | $354.81 | $549.54 |
CareFirst Setting Professional Modifier None Typical Low $162.18 Median $181.97 Typical High $213.80 | Professional | None | $162.18 | $181.97 | $213.80 |
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 $165.96 Median $295.12 Typical High $501.19 | Professional | None | $165.96 | $295.12 | $501.19 |
Kaiser Permanente Setting Professional Modifier None Typical Low $489.78 Median $575.44 Typical High $724.44 | Professional | None | $489.78 | $575.44 | $724.44 |
Medcost Setting Professional Modifier None Typical Low $245.47 Median $309.03 Typical High $363.08 | Professional | None | $245.47 | $309.03 | $363.08 |
Medcost Setting Facility Modifier None Typical Low $194.98 Median $257.04 Typical High $758.58 | Facility | None | $194.98 | $257.04 | $758.58 |
Medcost Setting Professional Modifier None Typical Low $239.88 Median $245.47 Typical High $426.58 | Professional | None | $239.88 | $245.47 | $426.58 |
Sentara Setting Facility Modifier None Typical Low $173.78 Median $912.01 Typical High $3,630.78 | Facility | None | $173.78 | $912.01 | $3,630.78 |
Sentara Setting Professional Modifier None Typical Low $190.55 Median $478.63 Typical High $741.31 | Professional | None | $190.55 | $478.63 | $741.31 |
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 $141.25 Median $257.04 Typical High $575.44 | Professional | None | $141.25 | $257.04 | $575.44 |
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 $97.72 Median $120.23 Typical High $275.42 | Professional | 52 · Reduced service | $97.72 | $120.23 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $47.86 Typical High $109.65 | Professional | 53 · Discontinued | $38.90 | $47.86 | $109.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $177.83 Typical High $416.87 | Professional | 54 · Surgery only | $144.54 | $177.83 | $416.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $35.48 Typical High $83.18 | Professional | 55 · Aftercare only | $28.84 | $35.48 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $23.99 Typical High $54.95 | Professional | 56 · Pre-op care only | $19.50 | $23.99 | $54.95 |
Where Virginia sits
The same service costs 5.4 times more in Colorado than in West Virginia. 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 $4,173WV $767
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.