How much rates vary
Facilitymedian $3,890 · 10th to 90th $575 to $10,000Professionalmedian $525 · 10th to 90th $437 to $692
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 $549.54 Median $5,248.07 Typical High $10,000.00 | Facility | None | $549.54 | $5,248.07 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $549.54 Median $549.54 Typical High $812.83 | Professional | None | $549.54 | $549.54 | $812.83 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,000.00 Median $6,760.83 Typical High $9,549.93 | Facility | None | $1,000.00 | $6,760.83 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $446.68 Median $512.86 Typical High $630.96 | Professional | None | $446.68 | $512.86 | $630.96 |
CareFirst Setting Professional Modifier None Typical Low $457.09 Median $501.19 Typical High $602.56 | Professional | None | $457.09 | $501.19 | $602.56 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $3,715.35 Typical High $7,079.46 | Facility | None | $645.65 | $3,715.35 | $7,079.46 |
Cigna Setting Professional Modifier None Typical Low $457.09 Median $489.78 Typical High $741.31 | Professional | None | $457.09 | $489.78 | $741.31 |
Kaiser Permanente Setting Professional Modifier None Typical Low $407.38 Median $457.09 Typical High $691.83 | Professional | None | $407.38 | $457.09 | $691.83 |
Medcost Setting Professional Modifier None Typical Low $741.31 Median $1,096.48 Typical High $1,096.48 | Professional | None | $741.31 | $1,096.48 | $1,096.48 |
Medcost Setting Facility Modifier None Typical Low $549.54 Median $691.83 Typical High $912.01 | Facility | None | $549.54 | $691.83 | $912.01 |
Medcost Setting Professional Modifier None Typical Low $501.19 Median $562.34 Typical High $691.83 | Professional | None | $501.19 | $562.34 | $691.83 |
Sentara Setting Facility Modifier None Typical Low $501.19 Median $1,737.80 Typical High $8,912.51 | Facility | None | $501.19 | $1,737.80 | $8,912.51 |
Sentara Setting Professional Modifier None Typical Low $501.19 Median $575.44 Typical High $831.76 | Professional | None | $501.19 | $575.44 | $831.76 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $5,011.87 Typical High $13,182.57 | Facility | None | $1,230.27 | $5,011.87 | $13,182.57 |
United Setting Professional Modifier None Typical Low $398.11 Median $478.63 Typical High $851.14 | Professional | None | $398.11 | $478.63 | $851.14 |
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 $269.15 Median $269.15 Typical High $275.42 | Professional | 52 · Reduced service | $269.15 | $269.15 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $109.65 Typical High $109.65 | Professional | 53 · Discontinued | $109.65 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $407.38 Typical High $416.87 | Professional | 54 · Surgery only | $407.38 | $407.38 | $416.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $81.28 Typical High $83.18 | Professional | 55 · Aftercare only | $81.28 | $81.28 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $54.95 Typical High $54.95 | Professional | 56 · Pre-op care only | $54.95 | $54.95 | $54.95 |
Where Virginia sits
The same service costs 5.9 times more in Alaska 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
AK $8,723MT $1,483
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.