How much rates vary
Facilitymedian $5,370 · 10th to 90th $398 to $15,488Professionalmedian $302 · 10th to 90th $257 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 $346.74 Median $5,370.32 Typical High $10,000.00 | Facility | None | $346.74 | $5,370.32 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $346.74 | Professional | None | $309.03 | $309.03 | $346.74 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,677.35 Median $6,456.54 Typical High $7,244.36 | Facility | None | $4,677.35 | $6,456.54 | $7,244.36 |
Anthem BCBS Setting Professional Modifier None Typical Low $257.04 Median $302.00 Typical High $354.81 | Professional | None | $257.04 | $302.00 | $354.81 |
CareFirst Setting Professional Modifier None Typical Low $263.03 Median $288.40 Typical High $338.84 | Professional | None | $263.03 | $288.40 | $338.84 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $3,019.95 Typical High $6,309.57 | Facility | None | $524.81 | $3,019.95 | $6,309.57 |
Cigna Setting Professional Modifier None Typical Low $269.15 Median $275.42 Typical High $467.74 | Professional | None | $269.15 | $275.42 | $467.74 |
Kaiser Permanente Setting Professional Modifier None Typical Low $245.47 Median $269.15 Typical High $489.78 | Professional | None | $245.47 | $269.15 | $489.78 |
Medcost Setting Professional Modifier None Typical Low $457.09 Median $562.34 Typical High $562.34 | Professional | None | $457.09 | $562.34 | $562.34 |
Medcost Setting Facility Modifier None Typical Low $346.74 Median $478.63 Typical High $575.44 | Facility | None | $346.74 | $478.63 | $575.44 |
Medcost Setting Professional Modifier None Typical Low $275.42 Median $436.52 Typical High $630.96 | Professional | None | $275.42 | $436.52 | $630.96 |
Sentara Setting Facility Modifier None Typical Low $302.00 Median $1,258.93 Typical High $10,715.19 | Facility | None | $302.00 | $1,258.93 | $10,715.19 |
Sentara Setting Professional Modifier None Typical Low $288.40 Median $363.08 Typical High $501.19 | Professional | None | $288.40 | $363.08 | $501.19 |
United Setting Facility Modifier None Typical Low $2,570.40 Median $10,000.00 Typical High $25,118.86 | Facility | None | $2,570.40 | $10,000.00 | $25,118.86 |
United Setting Professional Modifier None Typical Low $229.09 Median $288.40 Typical High $512.86 | Professional | None | $229.09 | $288.40 | $512.86 |
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 $154.88 Median $154.88 Typical High $173.78 | Professional | 52 · Reduced service | $154.88 | $154.88 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $61.66 Typical High $70.79 | Professional | 53 · Discontinued | $61.66 | $61.66 | $70.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $229.09 Median $229.09 Typical High $263.03 | Professional | 54 · Surgery only | $229.09 | $229.09 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $46.77 Typical High $52.48 | Professional | 55 · Aftercare only | $46.77 | $46.77 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $30.90 Typical High $34.67 | Professional | 56 · Pre-op care only | $30.90 | $30.90 | $34.67 |
Where Virginia sits
The same service costs 10.4 times more in Wyoming 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
WY $8,979MT $863
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.