How much rates vary
Facilitymedian $2,951 · 10th to 90th $240 to $9,550Professionalmedian $209 · 10th to 90th $166 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 $199.53 Median $3,801.89 Typical High $9,332.54 | Facility | None | $199.53 | $3,801.89 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $151.36 Median $199.53 Typical High $2,754.23 | Professional | None | $151.36 | $199.53 | $2,754.23 |
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 $169.82 Median $204.17 Typical High $263.03 | Professional | None | $169.82 | $204.17 | $263.03 |
CareFirst Setting Professional Modifier None Typical Low $177.83 Median $199.53 Typical High $2,511.89 | Professional | None | $177.83 | $199.53 | $2,511.89 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $1,737.80 Typical High $3,311.31 | Facility | None | $478.63 | $1,737.80 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $169.82 Median $213.80 Typical High $316.23 | Professional | None | $169.82 | $213.80 | $316.23 |
Kaiser Permanente Setting Professional Modifier None Typical Low $158.49 Median $190.55 Typical High $234.42 | Professional | None | $158.49 | $190.55 | $234.42 |
Medcost Setting Professional Modifier None Typical Low $251.19 Median $316.23 Typical High $316.23 | Professional | None | $251.19 | $316.23 | $316.23 |
Medcost Setting Facility Modifier None Typical Low $199.53 Median $245.47 Typical High $331.13 | Facility | None | $199.53 | $245.47 | $331.13 |
Medcost Setting Professional Modifier None Typical Low $234.42 Median $234.42 Typical High $234.42 | Professional | None | $234.42 | $234.42 | $234.42 |
Sentara Setting Facility Modifier None Typical Low $177.83 Median $933.25 Typical High $8,709.64 | Facility | None | $177.83 | $933.25 | $8,709.64 |
Sentara Setting Professional Modifier None Typical Low $181.97 Median $239.88 Typical High $4,073.80 | Professional | None | $181.97 | $239.88 | $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 $151.36 Median $245.47 Typical High $363.08 | Professional | None | $151.36 | $245.47 | $363.08 |
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 $75.86 Median $100.00 Typical High $100.00 | Professional | 52 · Reduced service | $75.86 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $40.74 Typical High $40.74 | Professional | 53 · Discontinued | $30.20 | $40.74 | $40.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $151.36 Typical High $151.36 | Professional | 54 · Surgery only | $114.82 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $30.20 Typical High $30.20 | Professional | 55 · Aftercare only | $22.91 | $30.20 | $30.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $19.95 Typical High $19.95 | Professional | 56 · Pre-op care only | $15.14 | $19.95 | $19.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $107.15 Median $141.25 Typical High $141.25 | Professional | 78 · Unplanned return to OR | $107.15 | $141.25 | $141.25 |
Where Virginia sits
The same service costs 8.1 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 $4,634MT $570
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.