How much rates vary
Facilitymedian $3,311 · 10th to 90th $427 to $10,000Professionalmedian $457 · 10th to 90th $339 to $708
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 $457.09 Median $4,073.80 Typical High $10,000.00 | Facility | None | $457.09 | $4,073.80 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $371.54 Median $457.09 Typical High $562.34 | Professional | None | $371.54 | $457.09 | $562.34 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,165.95 Median $7,413.10 Typical High $9,549.93 | Facility | None | $6,165.95 | $7,413.10 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $338.84 Median $416.87 Typical High $562.34 | Professional | None | $338.84 | $416.87 | $562.34 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $501.19 Median $630.96 Typical High $851.14 | Professional | 50 · Both sides | $501.19 | $630.96 | $851.14 |
CareFirst Setting Professional Modifier None Typical Low $331.13 Median $371.54 Typical High $6,918.31 | Professional | None | $331.13 | $371.54 | $6,918.31 |
Cigna Setting Facility Modifier None Typical Low $346.74 Median $2,454.71 Typical High $5,128.61 | Facility | None | $346.74 | $2,454.71 | $5,128.61 |
Cigna Setting Professional Modifier None Typical Low $354.81 Median $446.68 Typical High $707.95 | Professional | None | $354.81 | $446.68 | $707.95 |
Kaiser Permanente Setting Professional Modifier None Typical Low $302.00 Median $524.81 Typical High $645.65 | Professional | None | $302.00 | $524.81 | $645.65 |
Medcost Setting Professional Modifier None Typical Low $676.08 Median $831.76 Typical High $831.76 | Professional | None | $676.08 | $831.76 | $831.76 |
Medcost Setting Facility Modifier None Typical Low $398.11 Median $549.54 Typical High $794.33 | Facility | None | $398.11 | $549.54 | $794.33 |
Medcost Setting Professional Modifier None Typical Low $602.56 Median $602.56 Typical High $602.56 | Professional | None | $602.56 | $602.56 | $602.56 |
Sentara Setting Facility Modifier None Typical Low $363.08 Median $1,445.44 Typical High $8,709.64 | Facility | None | $363.08 | $1,445.44 | $8,709.64 |
Sentara Setting Professional Modifier None Typical Low $436.52 Median $616.60 Typical High $4,073.80 | Professional | None | $436.52 | $616.60 | $4,073.80 |
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 $316.23 Median $524.81 Typical High $812.83 | Professional | None | $316.23 | $524.81 | $812.83 |
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 $208.93 Typical High $239.88 | Professional | 52 · Reduced service | $181.97 | $208.93 | $239.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $83.18 Typical High $95.50 | Professional | 53 · Discontinued | $74.13 | $83.18 | $95.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $309.03 Typical High $363.08 | Professional | 54 · Surgery only | $275.42 | $309.03 | $363.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $63.10 Typical High $72.44 | Professional | 55 · Aftercare only | $54.95 | $63.10 | $72.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $41.69 Typical High $47.86 | Professional | 56 · Pre-op care only | $37.15 | $41.69 | $47.86 |
Where Virginia sits
The same service costs 6.3 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 $7,350MT $1,166
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.