How much rates vary
Facilitymedian $1,479 · 10th to 90th $282 to $5,888Professionalmedian $309 · 10th to 90th $186 to $603
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 $281.84 Median $977.24 Typical High $9,332.54 | Facility | None | $281.84 | $977.24 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $223.87 Median $398.11 Typical High $630.96 | Professional | None | $223.87 | $398.11 | $630.96 |
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 $186.21 Median $389.05 Typical High $602.56 | Professional | None | $186.21 | $389.05 | $602.56 |
CareFirst Setting Professional Modifier None Typical Low $186.21 Median $208.93 Typical High $245.47 | Professional | None | $186.21 | $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 $338.84 Typical High $562.34 | Professional | None | $190.55 | $338.84 | $562.34 |
Kaiser Permanente Setting Professional Modifier None Typical Low $537.03 Median $630.96 Typical High $794.33 | Professional | None | $537.03 | $630.96 | $794.33 |
Medcost Setting Professional Modifier None Typical Low $281.84 Median $354.81 Typical High $416.87 | Professional | None | $281.84 | $354.81 | $416.87 |
Medcost Setting Facility Modifier None Typical Low $223.87 Median $302.00 Typical High $831.76 | Facility | None | $223.87 | $302.00 | $831.76 |
Medcost Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $630.96 | Professional | None | $281.84 | $281.84 | $630.96 |
Sentara Setting Facility Modifier None Typical Low $199.53 Median $933.25 Typical High $3,630.78 | Facility | None | $199.53 | $933.25 | $3,630.78 |
Sentara Setting Professional Modifier None Typical Low $218.78 Median $524.81 Typical High $794.33 | Professional | None | $218.78 | $524.81 | $794.33 |
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 $162.18 Median $295.12 Typical High $630.96 | Professional | None | $162.18 | $295.12 | $630.96 |
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 $138.04 Typical High $302.00 | Professional | 52 · Reduced service | $112.20 | $138.04 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $54.95 Typical High $120.23 | Professional | 53 · Discontinued | $44.67 | $54.95 | $120.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $165.96 Median $208.93 Typical High $457.09 | Professional | 54 · Surgery only | $165.96 | $208.93 | $457.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $41.69 Typical High $91.20 | Professional | 55 · Aftercare only | $33.11 | $41.69 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $27.54 Typical High $60.26 | Professional | 56 · Pre-op care only | $22.39 | $27.54 | $60.26 |
Where Virginia sits
The same service costs 4.1 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 $4,142MT $1,002
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.