How much rates vary
Facilitymedian $2,884 · 10th to 90th $363 to $9,333Professionalmedian $955 · 10th to 90th $245 to $1,660
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 $363.08 Median $3,801.89 Typical High $9,332.54 | Facility | None | $363.08 | $3,801.89 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $263.03 Median $1,174.90 Typical High $1,513.56 | Professional | None | $263.03 | $1,174.90 | $1,513.56 |
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 $245.47 Median $645.65 Typical High $1,412.54 | Professional | None | $245.47 | $645.65 | $1,412.54 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $363.08 Median $977.24 Typical High $2,137.96 | Professional | 50 · Both sides | $363.08 | $977.24 | $2,137.96 |
CareFirst Setting Professional Modifier None Typical Low $239.88 Median $263.03 Typical High $331.13 | Professional | None | $239.88 | $263.03 | $331.13 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $1,949.84 Typical High $4,677.35 | Facility | None | $524.81 | $1,949.84 | $4,677.35 |
Cigna Setting Professional Modifier None Typical Low $251.19 Median $724.44 Typical High $1,698.24 | Professional | None | $251.19 | $724.44 | $1,698.24 |
Kaiser Permanente Setting Professional Modifier None Typical Low $213.80 Median $1,258.93 Typical High $1,548.82 | Professional | None | $213.80 | $1,258.93 | $1,548.82 |
Medcost Setting Facility Modifier None Typical Low $295.12 Median $478.63 Typical High $1,995.26 | Facility | None | $295.12 | $478.63 | $1,995.26 |
Medcost Setting Professional Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $1,513.56 | Professional | None | $1,513.56 | $1,513.56 | $1,513.56 |
Sentara Setting Facility Modifier None Typical Low $269.15 Median $1,318.26 Typical High $8,709.64 | Facility | None | $269.15 | $1,318.26 | $8,709.64 |
Sentara Setting Professional Modifier None Typical Low $1,148.15 Median $1,479.11 Typical High $5,128.61 | Professional | None | $1,148.15 | $1,479.11 | $5,128.61 |
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 $234.42 Median $758.58 Typical High $2,041.74 | Professional | None | $234.42 | $758.58 | $2,041.74 |
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 $131.83 Median $338.84 Typical High $660.69 | Professional | 52 · Reduced service | $131.83 | $338.84 | $660.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $134.90 Typical High $263.03 | Professional | 53 · Discontinued | $52.48 | $134.90 | $263.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $199.53 Median $512.86 Typical High $977.24 | Professional | 54 · Surgery only | $199.53 | $512.86 | $977.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $102.33 Typical High $194.98 | Professional | 55 · Aftercare only | $39.81 | $102.33 | $194.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $67.61 Typical High $131.83 | Professional | 56 · Pre-op care only | $26.30 | $67.61 | $131.83 |
Where Virginia sits
The same service costs 3.2 times more in Oklahoma than in Kentucky. 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
OK $6,075KY $1,891
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.