How much rates vary
Facilitymedian $3,090 · 10th to 90th $269 to $9,550Professionalmedian $240 · 10th to 90th $195 to $380
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 $239.88 Median $4,073.80 Typical High $10,000.00 | Facility | None | $239.88 | $4,073.80 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $234.42 Median $239.88 Typical High $2,238.72 | Professional | None | $234.42 | $239.88 | $2,238.72 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,677.35 Median $6,456.54 Typical High $7,244.36 | Facility | None | $4,677.35 | $6,456.54 | $7,244.36 |
Anthem BCBS Setting Professional Modifier None Typical Low $194.98 Median $234.42 Typical High $302.00 | Professional | None | $194.98 | $234.42 | $302.00 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $295.12 Median $354.81 Typical High $446.68 | Professional | 50 · Both sides | $295.12 | $354.81 | $446.68 |
CareFirst Setting Professional Modifier None Typical Low $204.17 Median $229.09 Typical High $3,467.37 | Professional | None | $204.17 | $229.09 | $3,467.37 |
Cigna Setting Facility Modifier None Typical Low $346.74 Median $1,659.59 Typical High $3,235.94 | Facility | None | $346.74 | $1,659.59 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $245.47 Typical High $363.08 | Professional | None | $204.17 | $245.47 | $363.08 |
Kaiser Permanente Setting Professional Modifier None Typical Low $186.21 Median $223.87 Typical High $275.42 | Professional | None | $186.21 | $223.87 | $275.42 |
Medcost Setting Professional Modifier None Typical Low $288.40 Median $354.81 Typical High $354.81 | Professional | None | $288.40 | $354.81 | $354.81 |
Medcost Setting Facility Modifier None Typical Low $239.88 Median $316.23 Typical High $389.05 | Facility | None | $239.88 | $316.23 | $389.05 |
Medcost Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $288.40 | Professional | None | $288.40 | $288.40 | $288.40 |
Sentara Setting Facility Modifier None Typical Low $204.17 Median $977.24 Typical High $8,709.64 | Facility | None | $204.17 | $977.24 | $8,709.64 |
Sentara Setting Professional Modifier None Typical Low $208.93 Median $281.84 Typical High $4,073.80 | Professional | None | $208.93 | $281.84 | $4,073.80 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $5,011.87 Typical High $13,182.57 | Facility | None | $1,230.27 | $5,011.87 | $13,182.57 |
United Setting Professional Modifier None Typical Low $173.78 Median $281.84 Typical High $426.58 | Professional | None | $173.78 | $281.84 | $426.58 |
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 $112.20 Median $120.23 Typical High $120.23 | Professional | 52 · Reduced service | $112.20 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $47.86 Typical High $47.86 | Professional | 53 · Discontinued | $44.67 | $47.86 | $47.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $165.96 Median $177.83 Typical High $181.97 | Professional | 54 · Surgery only | $165.96 | $177.83 | $181.97 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $35.48 Typical High $36.31 | Professional | 55 · Aftercare only | $33.11 | $35.48 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $23.99 Typical High $23.99 | Professional | 56 · Pre-op care only | $22.39 | $23.99 | $23.99 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $154.88 Median $165.96 Typical High $169.82 | Professional | 78 · Unplanned return to OR | $154.88 | $165.96 | $169.82 |
Where Virginia sits
The same service costs 9.6 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 $6,197MT $647
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.