How much rates vary
Facilitymedian $2,754 · 10th to 90th $263 to $9,772Professionalmedian $324 · 10th to 90th $195 to $501
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 $338.84 Median $4,365.16 Typical High $10,000.00 | Facility | None | $338.84 | $4,365.16 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $208.93 Median $338.84 Typical High $467.74 | Professional | None | $208.93 | $338.84 | $467.74 |
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 $316.23 Typical High $467.74 | Professional | None | $194.98 | $316.23 | $467.74 |
CareFirst Setting Professional Modifier None Typical Low $194.98 Median $213.80 Typical High $3,162.28 | Professional | None | $194.98 | $213.80 | $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 $204.17 Median $331.13 Typical High $524.81 | Professional | None | $204.17 | $331.13 | $524.81 |
Kaiser Permanente Setting Professional Modifier None Typical Low $173.78 Median $389.05 Typical High $478.63 | Professional | None | $173.78 | $389.05 | $478.63 |
Medcost Setting Professional Modifier None Typical Low $389.05 Median $478.63 Typical High $478.63 | Professional | None | $389.05 | $478.63 | $478.63 |
Medcost Setting Facility Modifier None Typical Low $229.09 Median $338.84 Typical High $549.54 | Facility | None | $229.09 | $338.84 | $549.54 |
Medcost Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $380.19 | Professional | None | $380.19 | $380.19 | $380.19 |
Sentara Setting Facility Modifier None Typical Low $194.98 Median $933.25 Typical High $8,709.64 | Facility | None | $194.98 | $933.25 | $8,709.64 |
Sentara Setting Professional Modifier None Typical Low $295.12 Median $407.38 Typical High $4,073.80 | Professional | None | $295.12 | $407.38 | $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 $177.83 Median $316.23 Typical High $575.44 | Professional | None | $177.83 | $316.23 | $575.44 |
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 $131.83 Typical High $199.53 | Professional | 52 · Reduced service | $104.71 | $131.83 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $42.66 Median $52.48 Typical High $79.43 | Professional | 53 · Discontinued | $42.66 | $52.48 | $79.43 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $158.49 Median $199.53 Typical High $295.12 | Professional | 54 · Surgery only | $158.49 | $199.53 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $39.81 Typical High $58.88 | Professional | 55 · Aftercare only | $31.62 | $39.81 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $26.30 Typical High $39.81 | Professional | 56 · Pre-op care only | $20.89 | $26.30 | $39.81 |
Where Virginia sits
The same service costs 7.9 times more in Oklahoma 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
OK $5,867MT $745
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.