How much rates vary
Facilitymedian $2,455 · 10th to 90th $170 to $9,550Professionalmedian $170 · 10th to 90th $138 to $257
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 $162.18 Median $3,235.94 Typical High $9,332.54 | Facility | None | $162.18 | $3,235.94 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $151.36 Median $169.82 Typical High $288.40 | Professional | None | $151.36 | $169.82 | $288.40 |
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 $134.90 Median $169.82 Typical High $213.80 | Professional | None | $134.90 | $169.82 | $213.80 |
CareFirst Setting Professional Modifier None Typical Low $138.04 Median $151.36 Typical High $3,467.37 | Professional | None | $138.04 | $151.36 | $3,467.37 |
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 $138.04 Median $173.78 Typical High $263.03 | Professional | None | $138.04 | $173.78 | $263.03 |
Kaiser Permanente Setting Professional Modifier None Typical Low $123.03 Median $194.98 Typical High $239.88 | Professional | None | $123.03 | $194.98 | $239.88 |
Medcost Setting Professional Modifier None Typical Low $208.93 Median $263.03 Typical High $263.03 | Professional | None | $208.93 | $263.03 | $263.03 |
Medcost Setting Facility Modifier None Typical Low $162.18 Median $208.93 Typical High $288.40 | Facility | None | $162.18 | $208.93 | $288.40 |
Medcost Setting Professional Modifier None Typical Low $208.93 Median $208.93 Typical High $208.93 | Professional | None | $208.93 | $208.93 | $208.93 |
Sentara Setting Facility Modifier None Typical Low $138.04 Median $912.01 Typical High $8,709.64 | Facility | None | $138.04 | $912.01 | $8,709.64 |
Sentara Setting Professional Modifier None Typical Low $158.49 Median $218.78 Typical High $4,073.80 | Professional | None | $158.49 | $218.78 | $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 $123.03 Median $199.53 Typical High $302.00 | Professional | None | $123.03 | $199.53 | $302.00 |
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 $74.13 Median $81.28 Typical High $89.13 | Professional | 52 · Reduced service | $74.13 | $81.28 | $89.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $32.36 Typical High $35.48 | Professional | 53 · Discontinued | $30.20 | $32.36 | $35.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $112.20 Median $120.23 Typical High $134.90 | Professional | 54 · Surgery only | $112.20 | $120.23 | $134.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $23.99 Typical High $26.92 | Professional | 55 · Aftercare only | $22.39 | $23.99 | $26.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $16.22 Typical High $17.78 | Professional | 56 · Pre-op care only | $15.14 | $16.22 | $17.78 |
Where Virginia sits
The same service costs 10.0 times more in Colorado 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
CO $4,594ND $460
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.