How much rates vary
Facilitymedian $1,413 · 10th to 90th $162 to $5,129Professionalmedian $741 · 10th to 90th $115 to $1,585
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 $169.82 Median $3,467.37 Typical High $9,332.54 | Facility | None | $169.82 | $3,467.37 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $131.83 Median $933.25 Typical High $1,584.89 | Professional | None | $131.83 | $933.25 | $1,584.89 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,698.24 Median $2,398.83 Typical High $2,951.21 | Facility | None | $1,698.24 | $2,398.83 | $2,951.21 |
Anthem BCBS Setting Professional Modifier None Typical Low $112.20 Median $851.14 Typical High $1,513.56 | Professional | None | $112.20 | $851.14 | $1,513.56 |
CareFirst Setting Professional Modifier None Typical Low $120.23 Median $131.83 Typical High $151.36 | Professional | None | $120.23 | $131.83 | $151.36 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $954.99 Typical High $3,548.13 | Facility | None | $524.81 | $954.99 | $3,548.13 |
Cigna Setting Professional Modifier None Typical Low $117.49 Median $309.03 Typical High $1,380.38 | Professional | None | $117.49 | $309.03 | $1,380.38 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,174.90 Median $1,412.54 Typical High $1,737.80 | Professional | None | $1,174.90 | $1,412.54 | $1,737.80 |
Medcost Setting Professional Modifier None Typical Low $3,090.30 Median $3,090.30 Typical High $3,090.30 | Professional | None | $3,090.30 | $3,090.30 | $3,090.30 |
Medcost Setting Facility Modifier None Typical Low $138.04 Median $223.87 Typical High $1,949.84 | Facility | None | $138.04 | $223.87 | $1,949.84 |
Medcost Setting Professional Modifier None Typical Low $954.99 Median $1,174.90 Typical High $1,318.26 | Professional | None | $954.99 | $1,174.90 | $1,318.26 |
Sentara Setting Facility Modifier None Typical Low $125.89 Median $616.60 Typical High $2,951.21 | Facility | None | $125.89 | $616.60 | $2,951.21 |
Sentara Setting Professional Modifier None Typical Low $1,047.13 Median $1,202.26 Typical High $2,041.74 | Professional | None | $1,047.13 | $1,202.26 | $2,041.74 |
United Setting Facility Modifier None Typical Low $323.59 Median $1,445.44 Typical High $3,630.78 | Facility | None | $323.59 | $1,445.44 | $3,630.78 |
United Setting Professional Modifier None Typical Low $104.71 Median $724.44 Typical High $1,621.81 | Professional | None | $104.71 | $724.44 | $1,621.81 |
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 $66.07 Median $120.23 Typical High $794.33 | Professional | 52 · Reduced service | $66.07 | $120.23 | $794.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.92 Median $47.86 Typical High $316.23 | Professional | 53 · Discontinued | $26.92 | $47.86 | $316.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $100.00 Median $181.97 Typical High $1,202.26 | Professional | 54 · Surgery only | $100.00 | $181.97 | $1,202.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $36.31 Typical High $239.88 | Professional | 55 · Aftercare only | $19.95 | $36.31 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $23.99 Typical High $158.49 | Professional | 56 · Pre-op care only | $13.18 | $23.99 | $158.49 |
Where Virginia sits
The same service costs 5.5 times more in Hawaii than in Maryland. 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
HI $4,440MD $808
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.