How much rates vary
Facilitymedian $2,455 · 10th to 90th $245 to $9,333Professionalmedian $372 · 10th to 90th $174 to $676
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 $316.23 Median $2,238.72 Typical High $9,332.54 | Facility | None | $316.23 | $2,238.72 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $204.17 Median $478.63 Typical High $676.08 | Professional | None | $204.17 | $478.63 | $676.08 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,884.03 Median $3,715.35 Typical High $4,265.80 | Facility | None | $2,884.03 | $3,715.35 | $4,265.80 |
Anthem BCBS Setting Professional Modifier None Typical Low $173.78 Median $426.58 Typical High $676.08 | Professional | None | $173.78 | $426.58 | $676.08 |
CareFirst Setting Professional Modifier None Typical Low $173.78 Median $190.55 Typical High $223.87 | Professional | None | $173.78 | $190.55 | $223.87 |
Cigna Setting Facility Modifier None Typical Low $346.74 Median $1,445.44 Typical High $2,691.53 | Facility | None | $346.74 | $1,445.44 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $457.09 Typical High $660.69 | Professional | None | $177.83 | $457.09 | $660.69 |
Kaiser Permanente Setting Professional Modifier None Typical Low $602.56 Median $724.44 Typical High $891.25 | Professional | None | $602.56 | $724.44 | $891.25 |
Medcost Setting Professional Modifier None Typical Low $537.03 Median $676.08 Typical High $676.08 | Professional | None | $537.03 | $676.08 | $676.08 |
Medcost Setting Facility Modifier None Typical Low $204.17 Median $331.13 Typical High $954.99 | Facility | None | $204.17 | $331.13 | $954.99 |
Medcost Setting Professional Modifier None Typical Low $281.84 Median $380.19 Typical High $602.56 | Professional | None | $281.84 | $380.19 | $602.56 |
Sentara Setting Facility Modifier None Typical Low $158.49 Median $933.25 Typical High $8,709.64 | Facility | None | $158.49 | $933.25 | $8,709.64 |
Sentara Setting Professional Modifier None Typical Low $309.03 Median $588.84 Typical High $912.01 | Professional | None | $309.03 | $588.84 | $912.01 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $5,011.87 Typical High $13,182.57 | Facility | None | $1,230.27 | $5,011.87 | $13,182.57 |
United Setting Professional Modifier None Typical Low $147.91 Median $354.81 Typical High $724.44 | Professional | None | $147.91 | $354.81 | $724.44 |
6 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 $102.33 Median $186.21 Typical High $338.84 | Professional | 52 · Reduced service | $102.33 | $186.21 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $74.13 Typical High $134.90 | Professional | 53 · Discontinued | $40.74 | $74.13 | $134.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $151.36 Median $275.42 Typical High $512.86 | Professional | 54 · Surgery only | $151.36 | $275.42 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $54.95 Typical High $102.33 | Professional | 55 · Aftercare only | $30.90 | $54.95 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $37.15 Typical High $67.61 | Professional | 56 · Pre-op care only | $20.42 | $37.15 | $67.61 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $141.25 Median $257.04 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $141.25 | $257.04 | $478.63 |
Where Virginia sits
The same service costs 4.4 times more in Colorado 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
CO $4,844ND $1,099
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.