How much rates vary
Facilitymedian $2,042 · 10th to 90th $457 to $7,413Professionalmedian $417 · 10th to 90th $347 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 $436.52 Median $4,786.30 Typical High $10,000.00 | Facility | None | $436.52 | $4,786.30 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $426.58 Median $436.52 Typical High $630.96 | Professional | None | $426.58 | $436.52 | $630.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,000.00 Median $6,025.60 Typical High $7,244.36 | Facility | None | $1,000.00 | $6,025.60 | $7,244.36 |
Anthem BCBS Setting Professional Modifier None Typical Low $346.74 Median $407.38 Typical High $489.78 | Professional | None | $346.74 | $407.38 | $489.78 |
CareFirst Setting Professional Modifier None Typical Low $354.81 Median $398.11 Typical High $467.74 | Professional | None | $354.81 | $398.11 | $467.74 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $1,318.26 Typical High $3,090.30 | Facility | None | $645.65 | $1,318.26 | $3,090.30 |
Cigna Setting Professional Modifier None Typical Low $363.08 Median $380.19 Typical High $588.84 | Professional | None | $363.08 | $380.19 | $588.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $316.23 Median $354.81 Typical High $537.03 | Professional | None | $316.23 | $354.81 | $537.03 |
Medcost Setting Professional Modifier None Typical Low $575.44 Median $851.14 Typical High $851.14 | Professional | None | $575.44 | $851.14 | $851.14 |
Medcost Setting Facility Modifier None Typical Low $436.52 Median $549.54 Typical High $707.95 | Facility | None | $436.52 | $549.54 | $707.95 |
Medcost Setting Professional Modifier None Typical Low $489.78 Median $512.86 Typical High $549.54 | Professional | None | $489.78 | $512.86 | $549.54 |
Sentara Setting Facility Modifier None Typical Low $398.11 Median $1,445.44 Typical High $8,709.64 | Facility | None | $398.11 | $1,445.44 | $8,709.64 |
Sentara Setting Professional Modifier None Typical Low $389.05 Median $457.09 Typical High $660.69 | Professional | None | $389.05 | $457.09 | $660.69 |
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 $309.03 Median $380.19 Typical High $676.08 | Professional | None | $309.03 | $380.19 | $676.08 |
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 $213.80 Median $213.80 Typical High $218.78 | Professional | 52 · Reduced service | $213.80 | $213.80 | $218.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $85.11 Median $85.11 Typical High $87.10 | Professional | 53 · Discontinued | $85.11 | $85.11 | $87.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $316.23 Typical High $323.59 | Professional | 54 · Surgery only | $316.23 | $316.23 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $63.10 Typical High $64.57 | Professional | 55 · Aftercare only | $63.10 | $63.10 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $42.66 Typical High $43.65 | Professional | 56 · Pre-op care only | $42.66 | $42.66 | $43.65 |
Where Virginia sits
The same service costs 5.0 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 $5,749MT $1,151
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.