How much rates vary
Facilitymedian $1,862 · 10th to 90th $126 to $5,754Professionalmedian $141 · 10th to 90th $95 to $219
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 $154.88 Median $3,981.07 Typical High $9,332.54 | Facility | None | $154.88 | $3,981.07 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $107.15 Median $154.88 Typical High $245.47 | Professional | None | $107.15 | $154.88 | $245.47 |
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 $95.50 Median $134.90 Typical High $190.55 | Professional | None | $95.50 | $134.90 | $190.55 |
CareFirst Setting Professional Modifier None Typical Low $95.50 Median $107.15 Typical High $2,454.71 | Professional | None | $95.50 | $107.15 | $2,454.71 |
Cigna Setting Facility Modifier None Typical Low $346.74 Median $1,148.15 Typical High $2,187.76 | Facility | None | $346.74 | $1,148.15 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $97.72 Median $141.25 Typical High $218.78 | Professional | None | $97.72 | $141.25 | $218.78 |
Kaiser Permanente Setting Professional Modifier None Typical Low $89.13 Median $169.82 Typical High $208.93 | Professional | None | $89.13 | $169.82 | $208.93 |
Medcost Setting Professional Modifier None Typical Low $169.82 Median $208.93 Typical High $208.93 | Professional | None | $169.82 | $208.93 | $208.93 |
Medcost Setting Facility Modifier None Typical Low $107.15 Median $154.88 Typical High $251.19 | Facility | None | $107.15 | $154.88 | $251.19 |
Medcost Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $181.97 | Professional | None | $181.97 | $181.97 | $181.97 |
Sentara Setting Facility Modifier None Typical Low $83.18 Median $891.25 Typical High $3,630.78 | Facility | None | $83.18 | $891.25 | $3,630.78 |
Sentara Setting Professional Modifier None Typical Low $138.04 Median $181.97 Typical High $2,137.96 | Professional | None | $138.04 | $181.97 | $2,137.96 |
United Setting Facility Modifier None Typical Low $588.84 Median $2,187.76 Typical High $5,888.44 | Facility | None | $588.84 | $2,187.76 | $5,888.44 |
United Setting Professional Modifier None Typical Low $83.18 Median $141.25 Typical High $239.88 | Professional | None | $83.18 | $141.25 | $239.88 |
6 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 $53.70 Median $67.61 Typical High $87.10 | Professional | 52 · Reduced service | $53.70 | $67.61 | $87.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $26.92 Typical High $34.67 | Professional | 53 · Discontinued | $21.88 | $26.92 | $34.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $81.28 Median $100.00 Typical High $128.82 | Professional | 54 · Surgery only | $81.28 | $100.00 | $128.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $19.95 Typical High $25.70 | Professional | 55 · Aftercare only | $16.22 | $19.95 | $25.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $13.49 Typical High $17.38 | Professional | 56 · Pre-op care only | $10.72 | $13.49 | $17.38 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $75.86 Median $93.33 Typical High $120.23 | Professional | 78 · Unplanned return to OR | $75.86 | $93.33 | $120.23 |
Where Virginia sits
The same service costs 13.0 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 $4,547MT $350
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.