How much rates vary
Facilitymedian $3,388 · 10th to 90th $427 to $13,183Professionalmedian $417 · 10th to 90th $347 to $661
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 $512.86 Median $2,818.38 Typical High $9,332.54 | Facility | None | $512.86 | $2,818.38 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $398.11 Median $407.38 Typical High $2,238.72 | Professional | None | $398.11 | $407.38 | $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 $346.74 Median $407.38 Typical High $524.81 | Professional | None | $346.74 | $407.38 | $524.81 |
CareFirst Setting Professional Modifier None Typical Low $363.08 Median $398.11 Typical High $4,365.16 | Professional | None | $363.08 | $398.11 | $4,365.16 |
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 $363.08 Median $416.87 Typical High $630.96 | Professional | None | $363.08 | $416.87 | $630.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $331.13 Median $398.11 Typical High $489.78 | Professional | None | $331.13 | $398.11 | $489.78 |
Medcost Setting Professional Modifier None Typical Low $436.52 Median $537.03 Typical High $537.03 | Professional | None | $436.52 | $537.03 | $537.03 |
Medcost Setting Facility Modifier None Typical Low $407.38 Median $537.03 Typical High $676.08 | Facility | None | $407.38 | $537.03 | $676.08 |
Medcost Setting Professional Modifier None Typical Low $489.78 Median $489.78 Typical High $489.78 | Professional | None | $489.78 | $489.78 | $489.78 |
Sentara Setting Facility Modifier None Typical Low $316.23 Median $1,659.59 Typical High $10,232.93 | Facility | None | $316.23 | $1,659.59 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $338.84 Median $478.63 Typical High $7,413.10 | Professional | None | $338.84 | $478.63 | $7,413.10 |
United Setting Facility Modifier None Typical Low $1,995.26 Median $8,511.38 Typical High $20,417.38 | Facility | None | $1,995.26 | $8,511.38 | $20,417.38 |
United Setting Professional Modifier None Typical Low $302.00 Median $457.09 Typical High $741.31 | Professional | None | $302.00 | $457.09 | $741.31 |
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 $194.98 Median $204.17 Typical High $213.80 | Professional | 52 · Reduced service | $194.98 | $204.17 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $77.62 Median $83.18 Typical High $85.11 | Professional | 53 · Discontinued | $77.62 | $83.18 | $85.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $288.40 Median $309.03 Typical High $316.23 | Professional | 54 · Surgery only | $288.40 | $309.03 | $316.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $61.66 Typical High $63.10 | Professional | 55 · Aftercare only | $58.88 | $61.66 | $63.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $40.74 Typical High $42.66 | Professional | 56 · Pre-op care only | $38.90 | $40.74 | $42.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $269.15 Median $288.40 Typical High $295.12 | Professional | 78 · Unplanned return to OR | $269.15 | $288.40 | $295.12 |
Where Virginia sits
The same service costs 5.9 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 $6,847MT $1,164
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.