How much rates vary
Facilitymedian $2,344 · 10th to 90th $389 to $8,318Professionalmedian $316 · 10th to 90th $269 to $427
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 $331.13 Median $4,786.30 Typical High $14,125.38 | Facility | None | $331.13 | $4,786.30 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $331.13 | Professional | None | $331.13 | $331.13 | $331.13 |
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 $269.15 Median $316.23 Typical High $371.54 | Professional | None | $269.15 | $316.23 | $371.54 |
CareFirst Setting Professional Modifier None Typical Low $275.42 Median $302.00 Typical High $363.08 | Professional | None | $275.42 | $302.00 | $363.08 |
Cigna Setting Facility Modifier None Typical Low $616.60 Median $4,265.80 Typical High $8,511.38 | Facility | None | $616.60 | $4,265.80 | $8,511.38 |
Cigna Setting Professional Modifier None Typical Low $275.42 Median $295.12 Typical High $489.78 | Professional | None | $275.42 | $295.12 | $489.78 |
Kaiser Permanente Setting Professional Modifier None Typical Low $245.47 Median $275.42 Typical High $416.87 | Professional | None | $245.47 | $275.42 | $416.87 |
Medcost Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $660.69 | Professional | None | $660.69 | $660.69 | $660.69 |
Medcost Setting Facility Modifier None Typical Low $331.13 Median $446.68 Typical High $549.54 | Facility | None | $331.13 | $446.68 | $549.54 |
Medcost Setting Professional Modifier None Typical Low $346.74 Median $380.19 Typical High $457.09 | Professional | None | $346.74 | $380.19 | $457.09 |
Sentara Setting Facility Modifier None Typical Low $309.03 Median $1,071.52 Typical High $7,413.10 | Facility | None | $309.03 | $1,071.52 | $7,413.10 |
Sentara Setting Professional Modifier None Typical Low $302.00 Median $389.05 Typical High $524.81 | Professional | None | $302.00 | $389.05 | $524.81 |
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 $239.88 Median $295.12 Typical High $524.81 | Professional | None | $239.88 | $295.12 | $524.81 |
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 $165.96 Median $165.96 Typical High $165.96 | Professional | 52 · Reduced service | $165.96 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $66.07 Typical High $66.07 | Professional | 53 · Discontinued | $66.07 | $66.07 | $66.07 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $245.47 Typical High $251.19 | Professional | 54 · Surgery only | $245.47 | $245.47 | $251.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $48.98 Typical High $50.12 | Professional | 55 · Aftercare only | $48.98 | $48.98 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | 56 · Pre-op care only | $33.11 | $33.11 | $33.11 |
Where Virginia sits
The same service costs 7.8 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 $7,005MT $893
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.