How much rates vary
Facilitymedian $9,333 · 10th to 90th $646 to $22,387Professionalmedian $646 · 10th to 90th $525 to $1,023
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 $645.65 Median $7,079.46 Typical High $13,182.57 | Facility | None | $645.65 | $7,079.46 | $13,182.57 |
Aetna Setting Professional Modifier None Typical Low $588.84 Median $645.65 Typical High $3,981.07 | Professional | None | $588.84 | $645.65 | $3,981.07 |
Anthem BCBS Setting Facility Modifier None Typical Low $10,964.78 Median $13,803.84 Typical High $15,848.93 | Facility | None | $10,964.78 | $13,803.84 | $15,848.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $537.03 Median $645.65 Typical High $831.76 | Professional | None | $537.03 | $645.65 | $831.76 |
CareFirst Setting Professional Modifier None Typical Low $562.34 Median $616.60 Typical High $8,511.38 | Professional | None | $562.34 | $616.60 | $8,511.38 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $6,918.31 Typical High $14,125.38 | Facility | None | $512.86 | $6,918.31 | $14,125.38 |
Cigna Setting Professional Modifier None Typical Low $524.81 Median $645.65 Typical High $977.24 | Professional | None | $524.81 | $645.65 | $977.24 |
Kaiser Permanente Setting Professional Modifier None Typical Low $489.78 Median $588.84 Typical High $724.44 | Professional | None | $489.78 | $588.84 | $724.44 |
Medcost Setting Professional Modifier None Typical Low $776.25 Median $977.24 Typical High $977.24 | Professional | None | $776.25 | $977.24 | $977.24 |
Medcost Setting Facility Modifier None Typical Low $645.65 Median $776.25 Typical High $1,047.13 | Facility | None | $645.65 | $776.25 | $1,047.13 |
Medcost Setting Professional Modifier None Typical Low $724.44 Median $724.44 Typical High $724.44 | Professional | None | $724.44 | $724.44 | $724.44 |
Sentara Setting Facility Modifier None Typical Low $512.86 Median $2,137.96 Typical High $19,952.62 | Facility | None | $512.86 | $2,137.96 | $19,952.62 |
Sentara Setting Professional Modifier None Typical Low $537.03 Median $741.31 Typical High $7,413.10 | Professional | None | $537.03 | $741.31 | $7,413.10 |
United Setting Facility Modifier None Typical Low $4,570.88 Median $13,489.63 Typical High $36,307.81 | Facility | None | $4,570.88 | $13,489.63 | $36,307.81 |
United Setting Professional Modifier None Typical Low $467.74 Median $758.58 Typical High $1,096.48 | Professional | None | $467.74 | $758.58 | $1,096.48 |
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 $288.40 Median $323.59 Typical High $323.59 | Professional | 52 · Reduced service | $288.40 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $128.82 Typical High $128.82 | Professional | 53 · Discontinued | $114.82 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $489.78 Typical High $489.78 | Professional | 54 · Surgery only | $436.52 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $97.72 Typical High $97.72 | Professional | 55 · Aftercare only | $87.10 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $64.57 Typical High $64.57 | Professional | 56 · Pre-op care only | $57.54 | $64.57 | $64.57 |
Where Virginia sits
The same service costs 9.8 times more in Alaska 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
AK $17,480MT $1,783
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.