How much rates vary
Facilitymedian $1,023 · 10th to 90th $200 to $5,370Professionalmedian $263 · 10th to 90th $151 to $417
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 $218.78 Median $575.44 Typical High $8,317.64 | Facility | None | $218.78 | $575.44 | $8,317.64 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $35.48 Median $141.25 Typical High $316.23 | Facility | 53 · Discontinued | $35.48 | $141.25 | $316.23 |
Aetna Setting Professional Modifier None Typical Low $177.83 Median $316.23 Typical High $398.11 | Professional | None | $177.83 | $316.23 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $89.13 Typical High $190.55 | Professional | 53 · Discontinued | $35.48 | $89.13 | $190.55 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,000.00 Median $2,187.76 Typical High $2,951.21 | Facility | None | $1,000.00 | $2,187.76 | $2,951.21 |
Anthem BCBS Setting Professional Modifier None Typical Low $147.91 Median $257.04 Typical High $380.19 | Professional | None | $147.91 | $257.04 | $380.19 |
Anthem BCBS Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $158.49 Typical High $371.54 | Professional | 53 · Discontinued | $63.10 | $158.49 | $371.54 |
CareFirst Setting Professional Modifier None Typical Low $151.36 Median $165.96 Typical High $194.98 | Professional | None | $151.36 | $165.96 | $194.98 |
Cigna Setting Facility Modifier None Typical Low $346.74 Median $630.96 Typical High $1,621.81 | Facility | None | $346.74 | $630.96 | $1,621.81 |
Cigna Setting Professional Modifier None Typical Low $154.88 Median $281.84 Typical High $416.87 | Professional | None | $154.88 | $281.84 | $416.87 |
Kaiser Permanente Setting Professional Modifier None Typical Low $346.74 Median $407.38 Typical High $588.84 | Professional | None | $346.74 | $407.38 | $588.84 |
Kaiser Permanente Setting Professional Modifier 53 · Discontinued Typical Low $346.74 Median $407.38 Typical High $512.86 | Professional | 53 · Discontinued | $346.74 | $407.38 | $512.86 |
Medcost Setting Professional Modifier None Typical Low $389.05 Median $489.78 Typical High $489.78 | Professional | None | $389.05 | $489.78 | $489.78 |
Medcost Setting Facility Modifier None Typical Low $177.83 Median $288.40 Typical High $537.03 | Facility | None | $177.83 | $288.40 | $537.03 |
Medcost Setting Professional Modifier None Typical Low $331.13 Median $363.08 Typical High $426.58 | Professional | None | $331.13 | $363.08 | $426.58 |
Sentara Setting Facility Modifier None Typical Low $151.36 Median $354.81 Typical High $3,162.28 | Facility | None | $151.36 | $354.81 | $3,162.28 |
Sentara Setting Professional Modifier None Typical Low $316.23 Median $380.19 Typical High $562.34 | Professional | None | $316.23 | $380.19 | $562.34 |
Sentara Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $190.55 Typical High $323.59 | Professional | 53 · Discontinued | $158.49 | $190.55 | $323.59 |
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 $131.83 Median $251.19 Typical High $457.09 | Professional | None | $131.83 | $251.19 | $457.09 |
4 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 $89.13 Median $154.88 Typical High $190.55 | Professional | 52 · Reduced service | $89.13 | $154.88 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $186.21 Typical High $288.40 | Professional | 54 · Surgery only | $134.90 | $186.21 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $45.71 Typical High $57.54 | Professional | 55 · Aftercare only | $26.92 | $45.71 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $30.20 Typical High $38.02 | Professional | 56 · Pre-op care only | $17.78 | $30.20 | $38.02 |
Where Virginia sits
The same service costs 4.7 times more in Connecticut than in North Dakota. 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
CT $3,190ND $672
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.