How much rates vary
Facilitymedian $501 · 10th to 90th $141 to $3,802Professionalmedian $214 · 10th to 90th $132 to $331
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 $151.36 Median $2,041.74 Typical High $9,332.54 | Facility | None | $151.36 | $2,041.74 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $151.36 Median $234.42 Typical High $407.38 | Professional | None | $151.36 | $234.42 | $407.38 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,698.24 Median $2,398.83 Typical High $2,951.21 | Facility | None | $1,698.24 | $2,398.83 | $2,951.21 |
Anthem BCBS Setting Professional Modifier None Typical Low $131.83 Median $204.17 Typical High $295.12 | Professional | None | $131.83 | $204.17 | $295.12 |
CareFirst Setting Professional Modifier None Typical Low $128.82 Median $144.54 Typical High $776.25 | Professional | None | $128.82 | $144.54 | $776.25 |
Cigna Setting Facility Modifier None Typical Low $141.25 Median $323.59 Typical High $1,621.81 | Facility | None | $141.25 | $323.59 | $1,621.81 |
Cigna Setting Professional Modifier None Typical Low $134.90 Median $218.78 Typical High $338.84 | Professional | None | $134.90 | $218.78 | $338.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $199.53 Median $295.12 Typical High $363.08 | Professional | None | $199.53 | $295.12 | $363.08 |
Medcost Setting Professional Modifier None Typical Low $309.03 Median $380.19 Typical High $380.19 | Professional | None | $309.03 | $380.19 | $380.19 |
Medcost Setting Facility Modifier None Typical Low $151.36 Median $234.42 Typical High $380.19 | Facility | None | $151.36 | $234.42 | $380.19 |
Medcost Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $281.84 | Professional | None | $281.84 | $281.84 | $281.84 |
Sentara Setting Facility Modifier None Typical Low $128.82 Median $371.54 Typical High $2,454.71 | Facility | None | $128.82 | $371.54 | $2,454.71 |
Sentara Setting Professional Modifier None Typical Low $190.55 Median $281.84 Typical High $1,071.52 | Professional | None | $190.55 | $281.84 | $1,071.52 |
United Setting Facility Modifier None Typical Low $100.00 Median $660.69 Typical High $2,041.74 | Facility | None | $100.00 | $660.69 | $2,041.74 |
United Setting Professional Modifier None Typical Low $120.23 Median $208.93 Typical High $380.19 | Professional | None | $120.23 | $208.93 | $380.19 |
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 $75.86 Median $97.72 Typical High $131.83 | Professional | 52 · Reduced service | $75.86 | $97.72 | $131.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $39.81 Typical High $52.48 | Professional | 53 · Discontinued | $30.20 | $39.81 | $52.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $147.91 Typical High $199.53 | Professional | 54 · Surgery only | $114.82 | $147.91 | $199.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $29.51 Typical High $39.81 | Professional | 55 · Aftercare only | $22.91 | $29.51 | $39.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $19.95 Typical High $26.30 | Professional | 56 · Pre-op care only | $15.14 | $19.95 | $26.30 |
Where Virginia sits
The same service costs 8.8 times more in New York than in Alabama. 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
NY $2,761AL $314
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.