How much rates vary
Facilitymedian $2,239 · 10th to 90th $427 to $10,000Professionalmedian $794 · 10th to 90th $339 to $1,413
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 $489.78 Median $1,737.80 Typical High $10,964.78 | Facility | None | $489.78 | $1,737.80 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $363.08 Median $933.25 Typical High $1,737.80 | Professional | None | $363.08 | $933.25 | $1,737.80 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,677.35 Median $6,456.54 Typical High $7,244.36 | Facility | None | $4,677.35 | $6,456.54 | $7,244.36 |
Anthem BCBS Setting Professional Modifier None Typical Low $338.84 Median $707.95 Typical High $1,148.15 | Professional | None | $338.84 | $707.95 | $1,148.15 |
CareFirst Setting Professional Modifier None Typical Low $331.13 Median $363.08 Typical High $4,365.16 | Professional | None | $331.13 | $363.08 | $4,365.16 |
Cigna Setting Facility Modifier None Typical Low $346.74 Median $1,659.59 Typical High $3,235.94 | Facility | None | $346.74 | $1,659.59 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $346.74 Median $724.44 Typical High $1,548.82 | Professional | None | $346.74 | $724.44 | $1,548.82 |
Kaiser Permanente Setting Professional Modifier None Typical Low $295.12 Median $1,023.29 Typical High $1,258.93 | Professional | None | $295.12 | $1,023.29 | $1,258.93 |
Medcost Setting Professional Modifier None Typical Low $1,621.81 Median $2,041.74 Typical High $2,041.74 | Professional | None | $1,621.81 | $2,041.74 | $2,041.74 |
Medcost Setting Facility Modifier None Typical Low $398.11 Median $645.65 Typical High $1,548.82 | Facility | None | $398.11 | $645.65 | $1,548.82 |
Medcost Setting Professional Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $1,202.26 | Professional | None | $1,202.26 | $1,202.26 | $1,202.26 |
Sentara Setting Facility Modifier None Typical Low $346.74 Median $1,445.44 Typical High $8,709.64 | Facility | None | $346.74 | $1,445.44 | $8,709.64 |
Sentara Setting Professional Modifier None Typical Low $831.76 Median $1,174.90 Typical High $4,570.88 | Professional | None | $831.76 | $1,174.90 | $4,570.88 |
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 $707.95 Typical High $1,698.24 | Professional | None | $316.23 | $707.95 | $1,698.24 |
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 $363.08 Typical High $501.19 | Professional | 52 · Reduced service | $181.97 | $363.08 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $144.54 Typical High $199.53 | Professional | 53 · Discontinued | $72.44 | $144.54 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $537.03 Typical High $758.58 | Professional | 54 · Surgery only | $269.15 | $537.03 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $107.15 Typical High $151.36 | Professional | 55 · Aftercare only | $53.70 | $107.15 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $72.44 Typical High $100.00 | Professional | 56 · Pre-op care only | $36.31 | $72.44 | $100.00 |
Where Virginia sits
The same service costs 3.7 times more in Wisconsin than in North Dakota. 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
WI $6,561ND $1,783
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.