How much rates vary
Facilitymedian $1,950 · 10th to 90th $380 to $6,166Professionalmedian $309 · 10th to 90th $257 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 $323.59 Median $4,786.30 Typical High $10,000.00 | Facility | None | $323.59 | $4,786.30 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $346.74 | Professional | None | $323.59 | $323.59 | $346.74 |
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 $263.03 Median $309.03 Typical High $371.54 | Professional | None | $263.03 | $309.03 | $371.54 |
CareFirst Setting Professional Modifier None Typical Low $269.15 Median $302.00 Typical High $354.81 | Professional | None | $269.15 | $302.00 | $354.81 |
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 $269.15 Median $288.40 Typical High $446.68 | Professional | None | $269.15 | $288.40 | $446.68 |
Kaiser Permanente Setting Professional Modifier None Typical Low $239.88 Median $269.15 Typical High $467.74 | Professional | None | $239.88 | $269.15 | $467.74 |
Medcost Setting Professional Modifier None Typical Low $398.11 Median $501.19 Typical High $501.19 | Professional | None | $398.11 | $501.19 | $501.19 |
Medcost Setting Facility Modifier None Typical Low $323.59 Median $416.87 Typical High $537.03 | Facility | None | $323.59 | $416.87 | $537.03 |
Medcost Setting Professional Modifier None Typical Low $371.54 Median $389.05 Typical High $630.96 | Professional | None | $371.54 | $389.05 | $630.96 |
Sentara Setting Facility Modifier None Typical Low $281.84 Median $1,071.52 Typical High $3,630.78 | Facility | None | $281.84 | $1,071.52 | $3,630.78 |
Sentara Setting Professional Modifier None Typical Low $288.40 Median $338.84 Typical High $512.86 | Professional | None | $288.40 | $338.84 | $512.86 |
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 $234.42 Median $275.42 Typical High $489.78 | Professional | None | $234.42 | $275.42 | $489.78 |
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 $162.18 Median $162.18 Typical High $162.18 | Professional | 52 · Reduced service | $162.18 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $64.57 Typical High $64.57 | Professional | 53 · Discontinued | $64.57 | $64.57 | $64.57 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $239.88 Typical High $245.47 | Professional | 54 · Surgery only | $239.88 | $239.88 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $47.86 Typical High $48.98 | Professional | 55 · Aftercare only | $47.86 | $47.86 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $32.36 Typical High $32.36 | Professional | 56 · Pre-op care only | $32.36 | $32.36 | $32.36 |
Where Virginia sits
The same service costs 5.2 times more in Oklahoma 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
OK $4,508MT $873
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.