How much rates vary
Facilitymedian $2,089 · 10th to 90th $200 to $9,333Professionalmedian $339 · 10th to 90th $138 to $617
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 $199.53 Median $794.33 Typical High $8,317.64 | Facility | None | $199.53 | $794.33 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $147.91 Median $416.87 Typical High $812.83 | Professional | None | $147.91 | $416.87 | $812.83 |
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 $138.04 Median $302.00 Typical High $489.78 | Professional | None | $138.04 | $302.00 | $489.78 |
CareFirst Setting Professional Modifier None Typical Low $134.90 Median $151.36 Typical High $3,162.28 | Professional | None | $134.90 | $151.36 | $3,162.28 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $1,122.02 Typical High $2,187.76 | Facility | None | $478.63 | $1,122.02 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $141.25 Median $316.23 Typical High $691.83 | Professional | None | $141.25 | $316.23 | $691.83 |
Kaiser Permanente Setting Professional Modifier None Typical Low $123.03 Median $416.87 Typical High $512.86 | Professional | None | $123.03 | $416.87 | $512.86 |
Medcost Setting Professional Modifier None Typical Low $758.58 Median $954.99 Typical High $954.99 | Professional | None | $758.58 | $954.99 | $954.99 |
Medcost Setting Facility Modifier None Typical Low $158.49 Median $263.03 Typical High $691.83 | Facility | None | $158.49 | $263.03 | $691.83 |
Medcost Setting Professional Modifier None Typical Low $562.34 Median $562.34 Typical High $562.34 | Professional | None | $562.34 | $562.34 | $562.34 |
Sentara Setting Facility Modifier None Typical Low $125.89 Median $933.25 Typical High $8,709.64 | Facility | None | $125.89 | $933.25 | $8,709.64 |
Sentara Setting Professional Modifier None Typical Low $316.23 Median $501.19 Typical High $4,073.80 | Professional | None | $316.23 | $501.19 | $4,073.80 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $4,897.79 Typical High $13,182.57 | Facility | None | $1,230.27 | $4,897.79 | $13,182.57 |
United Setting Professional Modifier None Typical Low $125.89 Median $316.23 Typical High $758.58 | Professional | None | $125.89 | $316.23 | $758.58 |
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 $74.13 Median $165.96 Typical High $213.80 | Professional | 52 · Reduced service | $74.13 | $165.96 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $29.51 Median $66.07 Typical High $87.10 | Professional | 53 · Discontinued | $29.51 | $66.07 | $87.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $112.20 Median $245.47 Typical High $323.59 | Professional | 54 · Surgery only | $112.20 | $245.47 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $48.98 Typical High $64.57 | Professional | 55 · Aftercare only | $22.39 | $48.98 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.79 Median $33.11 Typical High $42.66 | Professional | 56 · Pre-op care only | $14.79 | $33.11 | $42.66 |
Where Virginia sits
The same service costs 6.5 times more in Colorado than in West Virginia. 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 $4,737WV $727
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.