How much rates vary
Facilitymedian $2,570 · 10th to 90th $269 to $9,550Professionalmedian $661 · 10th to 90th $195 to $1,230
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 $269.15 Median $2,398.83 Typical High $9,332.54 | Facility | None | $269.15 | $2,398.83 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $213.80 Median $812.83 Typical High $1,548.82 | Professional | None | $213.80 | $812.83 | $1,548.82 |
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 $194.98 Median $524.81 Typical High $1,000.00 | Professional | None | $194.98 | $524.81 | $1,000.00 |
CareFirst Setting Professional Modifier None Typical Low $190.55 Median $213.80 Typical High $3,162.28 | Professional | None | $190.55 | $213.80 | $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 $199.53 Median $602.56 Typical High $1,348.96 | Professional | None | $199.53 | $602.56 | $1,348.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $169.82 Median $891.25 Typical High $1,096.48 | Professional | None | $169.82 | $891.25 | $1,096.48 |
Medcost Setting Professional Modifier None Typical Low $1,737.80 Median $2,187.76 Typical High $2,187.76 | Professional | None | $1,737.80 | $2,187.76 | $2,187.76 |
Medcost Setting Facility Modifier None Typical Low $229.09 Median $380.19 Typical High $1,348.96 | Facility | None | $229.09 | $380.19 | $1,348.96 |
Medcost Setting Professional Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $1,023.29 | Professional | None | $1,023.29 | $1,023.29 | $1,023.29 |
Sentara Setting Facility Modifier None Typical Low $165.96 Median $954.99 Typical High $8,709.64 | Facility | None | $165.96 | $954.99 | $8,709.64 |
Sentara Setting Professional Modifier None Typical Low $630.96 Median $1,023.29 Typical High $4,073.80 | Professional | None | $630.96 | $1,023.29 | $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 $177.83 Median $489.78 Typical High $1,479.11 | Professional | None | $177.83 | $489.78 | $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 $104.71 Median $275.42 Typical High $446.68 | Professional | 52 · Reduced service | $104.71 | $275.42 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $42.66 Median $109.65 Typical High $177.83 | Professional | 53 · Discontinued | $42.66 | $109.65 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $158.49 Median $407.38 Typical High $676.08 | Professional | 54 · Surgery only | $158.49 | $407.38 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $81.28 Typical High $134.90 | Professional | 55 · Aftercare only | $31.62 | $81.28 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.38 Median $54.95 Typical High $89.13 | Professional | 56 · Pre-op care only | $21.38 | $54.95 | $89.13 |
Where Virginia sits
The same service costs 3.8 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 $5,124MT $1,344
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.