How much rates vary
Facilitymedian $1,862 · 10th to 90th $263 to $6,166Professionalmedian $589 · 10th to 90th $186 to $1,148
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 $407.38 Median $4,073.80 Typical High $9,332.54 | Facility | None | $407.38 | $4,073.80 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $218.78 Median $812.83 Typical High $1,096.48 | Professional | None | $218.78 | $812.83 | $1,096.48 |
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 $181.97 Median $691.83 Typical High $1,047.13 | Professional | None | $181.97 | $691.83 | $1,047.13 |
CareFirst Setting Professional Modifier None Typical Low $190.55 Median $213.80 Typical High $245.47 | Professional | None | $190.55 | $213.80 | $245.47 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $1,230.27 Typical High $3,090.30 | Facility | None | $645.65 | $1,230.27 | $3,090.30 |
Cigna Setting Professional Modifier None Typical Low $186.21 Median $446.68 Typical High $1,148.15 | Professional | None | $186.21 | $446.68 | $1,148.15 |
Kaiser Permanente Setting Professional Modifier None Typical Low $812.83 Median $977.24 Typical High $1,348.96 | Professional | None | $812.83 | $977.24 | $1,348.96 |
Medcost Setting Professional Modifier None Typical Low $1,258.93 Median $2,187.76 Typical High $2,187.76 | Professional | None | $1,258.93 | $2,187.76 | $2,187.76 |
Medcost Setting Facility Modifier None Typical Low $223.87 Median $363.08 Typical High $1,513.56 | Facility | None | $223.87 | $363.08 | $1,513.56 |
Medcost Setting Professional Modifier None Typical Low $954.99 Median $1,148.15 Typical High $1,174.90 | Professional | None | $954.99 | $1,148.15 | $1,174.90 |
Sentara Setting Facility Modifier None Typical Low $204.17 Median $1,000.00 Typical High $3,715.35 | Facility | None | $204.17 | $1,000.00 | $3,715.35 |
Sentara Setting Professional Modifier None Typical Low $891.25 Median $1,000.00 Typical High $1,479.11 | Professional | None | $891.25 | $1,000.00 | $1,479.11 |
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 $169.82 Median $549.54 Typical High $1,348.96 | Professional | None | $169.82 | $549.54 | $1,348.96 |
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 $107.15 Median $194.98 Typical High $549.54 | Professional | 52 · Reduced service | $107.15 | $194.98 | $549.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $79.43 Typical High $218.78 | Professional | 53 · Discontinued | $43.65 | $79.43 | $218.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $162.18 Median $295.12 Typical High $831.76 | Professional | 54 · Surgery only | $162.18 | $295.12 | $831.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $32.36 Median $58.88 Typical High $165.96 | Professional | 55 · Aftercare only | $32.36 | $58.88 | $165.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $38.90 Typical High $109.65 | Professional | 56 · Pre-op care only | $21.88 | $38.90 | $109.65 |
Where Virginia sits
The same service costs 5.2 times more in Colorado 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
CO $5,090MD $977
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.