How much rates vary
Facilitymedian $2,138 · 10th to 90th $200 to $7,244Professionalmedian $170 · 10th to 90th $141 to $219
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 $173.78 Median $5,128.61 Typical High $10,000.00 | Facility | None | $173.78 | $5,128.61 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $173.78 Median $173.78 Typical High $173.78 | Professional | None | $173.78 | $173.78 | $173.78 |
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 $141.25 Median $165.96 Typical High $199.53 | Professional | None | $141.25 | $165.96 | $199.53 |
CareFirst Setting Professional Modifier None Typical Low $144.54 Median $162.18 Typical High $190.55 | Professional | None | $144.54 | $162.18 | $190.55 |
Cigna Setting Facility Modifier None Typical Low $616.60 Median $1,122.02 Typical High $3,090.30 | Facility | None | $616.60 | $1,122.02 | $3,090.30 |
Cigna Setting Professional Modifier None Typical Low $147.91 Median $154.88 Typical High $251.19 | Professional | None | $147.91 | $154.88 | $251.19 |
Kaiser Permanente Setting Professional Modifier None Typical Low $131.83 Median $147.91 Typical High $218.78 | Professional | None | $131.83 | $147.91 | $218.78 |
Medcost Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $354.81 | Professional | None | $354.81 | $354.81 | $354.81 |
Medcost Setting Facility Modifier None Typical Low $173.78 Median $213.80 Typical High $288.40 | Facility | None | $173.78 | $213.80 | $288.40 |
Medcost Setting Professional Modifier None Typical Low $79.43 Median $79.43 Typical High $218.78 | Professional | None | $79.43 | $79.43 | $218.78 |
Sentara Setting Facility Modifier None Typical Low $162.18 Median $891.25 Typical High $7,413.10 | Facility | None | $162.18 | $891.25 | $7,413.10 |
Sentara Setting Professional Modifier None Typical Low $158.49 Median $186.21 Typical High $263.03 | Professional | None | $158.49 | $186.21 | $263.03 |
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 $125.89 Median $151.36 Typical High $269.15 | Professional | None | $125.89 | $151.36 | $269.15 |
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 $87.10 Median $87.10 Typical High $87.10 | Professional | 52 · Reduced service | $87.10 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $34.67 Typical High $35.48 | Professional | 53 · Discontinued | $34.67 | $34.67 | $35.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $131.83 Median $131.83 Typical High $131.83 | Professional | 54 · Surgery only | $131.83 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $26.30 Typical High $26.30 | Professional | 55 · Aftercare only | $26.30 | $26.30 | $26.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $17.38 Typical High $17.38 | Professional | 56 · Pre-op care only | $17.38 | $17.38 | $17.38 |
Where Virginia sits
The same service costs 11.1 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 $5,221MT $469
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.