How much rates vary
Facilitymedian $2,570 · 10th to 90th $245 to $9,550Professionalmedian $617 · 10th to 90th $170 to $1,175
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 $245.47 Median $2,570.40 Typical High $9,332.54 | Facility | None | $245.47 | $2,570.40 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $181.97 Median $758.58 Typical High $1,479.11 | Professional | None | $181.97 | $758.58 | $1,479.11 |
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 $169.82 Median $549.54 Typical High $954.99 | Professional | None | $169.82 | $549.54 | $954.99 |
CareFirst Setting Professional Modifier None Typical Low $165.96 Median $186.21 Typical High $3,162.28 | Professional | None | $165.96 | $186.21 | $3,162.28 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $1,737.80 Typical High $3,235.94 | Facility | None | $478.63 | $1,737.80 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $173.78 Median $524.81 Typical High $1,318.26 | Professional | None | $173.78 | $524.81 | $1,318.26 |
Kaiser Permanente Setting Professional Modifier None Typical Low $147.91 Median $851.14 Typical High $1,047.13 | Professional | None | $147.91 | $851.14 | $1,047.13 |
Medcost Setting Professional Modifier None Typical Low $1,862.09 Median $2,344.23 Typical High $2,344.23 | Professional | None | $1,862.09 | $2,344.23 | $2,344.23 |
Medcost Setting Facility Modifier None Typical Low $199.53 Median $323.59 Typical High $1,288.25 | Facility | None | $199.53 | $323.59 | $1,288.25 |
Medcost Setting Professional Modifier None Typical Low $776.25 Median $776.25 Typical High $776.25 | Professional | None | $776.25 | $776.25 | $776.25 |
Sentara Setting Facility Modifier None Typical Low $186.21 Median $933.25 Typical High $8,709.64 | Facility | None | $186.21 | $933.25 | $8,709.64 |
Sentara Setting Professional Modifier None Typical Low $602.56 Median $977.24 Typical High $4,073.80 | Professional | None | $602.56 | $977.24 | $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 $162.18 Median $457.09 Typical High $1,479.11 | Professional | None | $162.18 | $457.09 | $1,479.11 |
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 $91.20 Median $234.42 Typical High $426.58 | Professional | 52 · Reduced service | $91.20 | $234.42 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $93.33 Typical High $173.78 | Professional | 53 · Discontinued | $36.31 | $93.33 | $173.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $354.81 Typical High $645.65 | Professional | 54 · Surgery only | $138.04 | $354.81 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $70.79 Typical High $128.82 | Professional | 55 · Aftercare only | $27.54 | $70.79 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $46.77 Typical High $87.10 | Professional | 56 · Pre-op care only | $18.20 | $46.77 | $87.10 |
Where Virginia sits
The same service costs 4.0 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 $5,041MT $1,267
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.