How much rates vary
Facilitymedian $1,905 · 10th to 90th $105 to $5,754Professionalmedian $89 · 10th to 90th $72 to $141
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 $89.13 Median $4,073.80 Typical High $10,000.00 | Facility | None | $89.13 | $4,073.80 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $83.18 Median $89.13 Typical High $2,570.40 | Professional | None | $83.18 | $89.13 | $2,570.40 |
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 $72.44 Median $87.10 Typical High $107.15 | Professional | None | $72.44 | $87.10 | $107.15 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $107.15 Median $128.82 Typical High $165.96 | Professional | 50 · Both sides | $107.15 | $128.82 | $165.96 |
CareFirst Setting Professional Modifier None Typical Low $75.86 Median $85.11 Typical High $2,454.71 | Professional | None | $75.86 | $85.11 | $2,454.71 |
Cigna Setting Facility Modifier None Typical Low $346.74 Median $1,023.29 Typical High $1,949.84 | Facility | None | $346.74 | $1,023.29 | $1,949.84 |
Cigna Setting Professional Modifier None Typical Low $75.86 Median $93.33 Typical High $141.25 | Professional | None | $75.86 | $93.33 | $141.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $69.18 Median $83.18 Typical High $102.33 | Professional | None | $69.18 | $83.18 | $102.33 |
Medcost Setting Professional Modifier None Typical Low $112.20 Median $141.25 Typical High $141.25 | Professional | None | $112.20 | $141.25 | $141.25 |
Medcost Setting Facility Modifier None Typical Low $89.13 Median $117.49 Typical High $144.54 | Facility | None | $89.13 | $117.49 | $144.54 |
Medcost Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $107.15 | Professional | None | $107.15 | $107.15 | $107.15 |
Sentara Setting Facility Modifier None Typical Low $81.28 Median $891.25 Typical High $3,630.78 | Facility | None | $81.28 | $891.25 | $3,630.78 |
Sentara Setting Professional Modifier None Typical Low $79.43 Median $107.15 Typical High $2,137.96 | Professional | None | $79.43 | $107.15 | $2,137.96 |
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 $64.57 Median $109.65 Typical High $158.49 | Professional | None | $64.57 | $109.65 | $158.49 |
6 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 $41.69 Median $43.65 Typical High $43.65 | Professional | 52 · Reduced service | $41.69 | $43.65 | $43.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $17.78 Typical High $17.78 | Professional | 53 · Discontinued | $16.60 | $17.78 | $17.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $61.66 Median $66.07 Typical High $66.07 | Professional | 54 · Surgery only | $61.66 | $66.07 | $66.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $13.18 Typical High $13.18 | Professional | 55 · Aftercare only | $12.59 | $13.18 | $13.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $8.91 Typical High $8.91 | Professional | 56 · Pre-op care only | $8.32 | $8.91 | $8.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $57.54 Median $61.66 Typical High $61.66 | Professional | 78 · Unplanned return to OR | $57.54 | $61.66 | $61.66 |
Where Virginia sits
The same service costs 18.4 times more in Colorado 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
CO $4,483MT $243
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.