How much rates vary
Facilitymedian $1,862 · 10th to 90th $251 to $5,754Professionalmedian $191 · 10th to 90th $158 to $275
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 $194.98 Median $4,365.16 Typical High $10,000.00 | Facility | None | $194.98 | $4,365.16 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $213.80 | Professional | None | $194.98 | $194.98 | $213.80 |
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 $158.49 Median $186.21 Typical High $223.87 | Professional | None | $158.49 | $186.21 | $223.87 |
CareFirst Setting Professional Modifier None Typical Low $162.18 Median $181.97 Typical High $213.80 | Professional | None | $162.18 | $181.97 | $213.80 |
Cigna Setting Facility Modifier None Typical Low $346.74 Median $741.31 Typical High $1,659.59 | Facility | None | $346.74 | $741.31 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $162.18 Median $173.78 Typical High $323.59 | Professional | None | $162.18 | $173.78 | $323.59 |
Kaiser Permanente Setting Professional Modifier None Typical Low $147.91 Median $165.96 Typical High $288.40 | Professional | None | $147.91 | $165.96 | $288.40 |
Medcost Setting Professional Modifier None Typical Low $302.00 Median $380.19 Typical High $380.19 | Professional | None | $302.00 | $380.19 | $380.19 |
Medcost Setting Facility Modifier None Typical Low $194.98 Median $316.23 Typical High $331.13 | Facility | None | $194.98 | $316.23 | $331.13 |
Medcost Setting Professional Modifier None Typical Low $257.04 Median $281.84 Typical High $309.03 | Professional | None | $257.04 | $281.84 | $309.03 |
Sentara Setting Facility Modifier None Typical Low $181.97 Median $933.25 Typical High $4,073.80 | Facility | None | $181.97 | $933.25 | $4,073.80 |
Sentara Setting Professional Modifier None Typical Low $173.78 Median $251.19 Typical High $331.13 | Professional | None | $173.78 | $251.19 | $331.13 |
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 $141.25 Median $194.98 Typical High $338.84 | Professional | None | $141.25 | $194.98 | $338.84 |
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 $97.72 Median $97.72 Typical High $97.72 | Professional | 52 · Reduced service | $97.72 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $38.90 Typical High $38.90 | Professional | 53 · Discontinued | $38.90 | $38.90 | $38.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $144.54 Typical High $144.54 | Professional | 54 · Surgery only | $144.54 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $28.84 Typical High $29.51 | Professional | 55 · Aftercare only | $28.84 | $28.84 | $29.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $19.50 Typical High $19.50 | Professional | 56 · Pre-op care only | $19.50 | $19.50 | $19.50 |
Where Virginia sits
The same service costs 7.7 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 $4,047MT $526
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.