How much rates vary
Facilitymedian $1,862 · 10th to 90th $174 to $5,754Professionalmedian $195 · 10th to 90th $132 to $295
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 $208.93 Median $3,981.07 Typical High $9,332.54 | Facility | None | $208.93 | $3,981.07 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $147.91 Median $208.93 Typical High $302.00 | Professional | None | $147.91 | $208.93 | $302.00 |
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 $131.83 Median $186.21 Typical High $263.03 | Professional | None | $131.83 | $186.21 | $263.03 |
CareFirst Setting Professional Modifier None Typical Low $131.83 Median $144.54 Typical High $2,454.71 | Professional | None | $131.83 | $144.54 | $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 $134.90 Median $199.53 Typical High $302.00 | Professional | None | $134.90 | $199.53 | $302.00 |
Kaiser Permanente Setting Professional Modifier None Typical Low $120.23 Median $234.42 Typical High $288.40 | Professional | None | $120.23 | $234.42 | $288.40 |
Medcost Setting Professional Modifier None Typical Low $245.47 Median $309.03 Typical High $309.03 | Professional | None | $245.47 | $309.03 | $309.03 |
Medcost Setting Facility Modifier None Typical Low $147.91 Median $208.93 Typical High $338.84 | Facility | None | $147.91 | $208.93 | $338.84 |
Medcost Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $245.47 | Professional | None | $245.47 | $245.47 | $245.47 |
Sentara Setting Facility Modifier None Typical Low $114.82 Median $912.01 Typical High $3,630.78 | Facility | None | $114.82 | $912.01 | $3,630.78 |
Sentara Setting Professional Modifier None Typical Low $186.21 Median $245.47 Typical High $2,137.96 | Professional | None | $186.21 | $245.47 | $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 $114.82 Median $194.98 Typical High $338.84 | Professional | None | $114.82 | $194.98 | $338.84 |
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 $74.13 Median $91.20 Typical High $117.49 | Professional | 52 · Reduced service | $74.13 | $91.20 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $29.51 Median $36.31 Typical High $46.77 | Professional | 53 · Discontinued | $29.51 | $36.31 | $46.77 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $109.65 Median $138.04 Typical High $173.78 | Professional | 54 · Surgery only | $109.65 | $138.04 | $173.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $27.54 Typical High $34.67 | Professional | 55 · Aftercare only | $21.88 | $27.54 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.79 Median $18.20 Typical High $23.44 | Professional | 56 · Pre-op care only | $14.79 | $18.20 | $23.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $102.33 Median $128.82 Typical High $162.18 | Professional | 78 · Unplanned return to OR | $102.33 | $128.82 | $162.18 |
Where Virginia sits
The same service costs 9.9 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 $4,605MT $466
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.