How much rates vary
Facilitymedian $2,455 · 10th to 90th $135 to $9,550Professionalmedian $112 · 10th to 90th $89 to $200
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 $134.90 Median $2,818.38 Typical High $9,332.54 | Facility | None | $134.90 | $2,818.38 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $102.33 Median $109.65 Typical High $2,041.74 | Professional | None | $102.33 | $109.65 | $2,041.74 |
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 $89.13 Median $107.15 Typical High $138.04 | Professional | None | $89.13 | $107.15 | $138.04 |
CareFirst Setting Professional Modifier None Typical Low $93.33 Median $102.33 Typical High $2,454.71 | Professional | None | $93.33 | $102.33 | $2,454.71 |
Cigna Setting Facility Modifier None Typical Low $346.74 Median $1,023.29 Typical High $1,949.84 | Facility | None | $346.74 | $1,023.29 | $1,949.84 |
Cigna Setting Professional Modifier None Typical Low $93.33 Median $112.20 Typical High $208.93 | Professional | None | $93.33 | $112.20 | $208.93 |
Kaiser Permanente Setting Professional Modifier None Typical Low $83.18 Median $97.72 Typical High $123.03 | Professional | None | $83.18 | $97.72 | $123.03 |
Medcost Setting Professional Modifier None Typical Low $234.42 Median $288.40 Typical High $288.40 | Professional | None | $234.42 | $288.40 | $288.40 |
Medcost Setting Facility Modifier None Typical Low $109.65 Median $144.54 Typical High $177.83 | Facility | None | $109.65 | $144.54 | $177.83 |
Medcost Setting Professional Modifier None Typical Low $131.83 Median $131.83 Typical High $131.83 | Professional | None | $131.83 | $131.83 | $131.83 |
Sentara Setting Facility Modifier None Typical Low $93.33 Median $912.01 Typical High $8,709.64 | Facility | None | $93.33 | $912.01 | $8,709.64 |
Sentara Setting Professional Modifier None Typical Low $100.00 Median $141.25 Typical High $4,073.80 | Professional | None | $100.00 | $141.25 | $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 $81.28 Median $134.90 Typical High $229.09 | Professional | None | $81.28 | $134.90 | $229.09 |
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 $51.29 Median $54.95 Typical High $54.95 | Professional | 52 · Reduced service | $51.29 | $54.95 | $54.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $21.88 Typical High $21.88 | Professional | 53 · Discontinued | $20.42 | $21.88 | $21.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $75.86 Median $83.18 Typical High $83.18 | Professional | 54 · Surgery only | $75.86 | $83.18 | $83.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $16.60 Typical High $16.60 | Professional | 55 · Aftercare only | $15.49 | $16.60 | $16.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $10.96 Typical High $10.96 | Professional | 56 · Pre-op care only | $10.23 | $10.96 | $10.96 |
Where Virginia sits
The same service costs 15.6 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 $4,608MT $296
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.