How much rates vary
Facilitymedian $4,898 · 10th to 90th $457 to $11,220Professionalmedian $363 · 10th to 90th $295 to $490
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 $371.54 Median $5,370.32 Typical High $10,000.00 | Facility | None | $371.54 | $5,370.32 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $371.54 | Professional | None | $363.08 | $363.08 | $371.54 |
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 $302.00 Median $363.08 Typical High $426.58 | Professional | None | $302.00 | $363.08 | $426.58 |
CareFirst Setting Professional Modifier None Typical Low $295.12 Median $323.59 Typical High $389.05 | Professional | None | $295.12 | $323.59 | $389.05 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $3,019.95 Typical High $8,128.31 | Facility | None | $524.81 | $3,019.95 | $8,128.31 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $331.13 Typical High $549.54 | Professional | None | $316.23 | $331.13 | $549.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $288.40 Median $323.59 Typical High $549.54 | Professional | None | $288.40 | $323.59 | $549.54 |
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 $371.54 Median $562.34 Typical High $602.56 | Facility | None | $371.54 | $562.34 | $602.56 |
Medcost Setting Professional Modifier None Typical Low $398.11 Median $512.86 Typical High $630.96 | Professional | None | $398.11 | $512.86 | $630.96 |
Sentara Setting Facility Modifier None Typical Low $346.74 Median $1,513.56 Typical High $10,232.93 | Facility | None | $346.74 | $1,513.56 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $338.84 Median $446.68 Typical High $602.56 | Professional | None | $338.84 | $446.68 | $602.56 |
United Setting Facility Modifier None Typical Low $1,548.82 Median $6,760.83 Typical High $17,378.01 | Facility | None | $1,548.82 | $6,760.83 | $17,378.01 |
United Setting Professional Modifier None Typical Low $275.42 Median $346.74 Typical High $602.56 | Professional | None | $275.42 | $346.74 | $602.56 |
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 $181.97 Median $181.97 Typical High $186.21 | Professional | 52 · Reduced service | $181.97 | $181.97 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $74.13 Typical High $74.13 | Professional | 53 · Discontinued | $74.13 | $74.13 | $74.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $275.42 Typical High $281.84 | Professional | 54 · Surgery only | $275.42 | $275.42 | $281.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $54.95 Typical High $56.23 | Professional | 55 · Aftercare only | $54.95 | $54.95 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $36.31 Typical High $37.15 | Professional | 56 · Pre-op care only | $36.31 | $36.31 | $37.15 |
Where Virginia sits
The same service costs 7.2 times more in Wisconsin 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
WI $7,422MT $1,038
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.