How much rates vary
Facilitymedian $871 · 10th to 90th $151 to $4,074Professionalmedian $138 · 10th to 90th $105 to $245
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 $158.49 Median $316.23 Typical High $7,079.46 | Facility | None | $158.49 | $316.23 | $7,079.46 |
Aetna Setting Professional Modifier None Typical Low $112.20 Median $173.78 Typical High $288.40 | Professional | None | $112.20 | $173.78 | $288.40 |
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 $104.71 Median $125.89 Typical High $151.36 | Professional | None | $104.71 | $125.89 | $151.36 |
CareFirst Setting Professional Modifier None Typical Low $112.20 Median $123.03 Typical High $162.18 | Professional | None | $112.20 | $123.03 | $162.18 |
Cigna Setting Facility Modifier None Typical Low $346.74 Median $501.19 Typical High $1,621.81 | Facility | None | $346.74 | $501.19 | $1,621.81 |
Cigna Setting Professional Modifier None Typical Low $102.33 Median $154.88 Typical High $239.88 | Professional | None | $102.33 | $154.88 | $239.88 |
Kaiser Permanente Setting Professional Modifier None Typical Low $169.82 Median $204.17 Typical High $251.19 | Professional | None | $169.82 | $204.17 | $251.19 |
Medcost Setting Professional Modifier None Typical Low $239.88 Median $302.00 Typical High $302.00 | Professional | None | $239.88 | $302.00 | $302.00 |
Medcost Setting Facility Modifier None Typical Low $128.82 Median $194.98 Typical High $316.23 | Facility | None | $128.82 | $194.98 | $316.23 |
Medcost Setting Professional Modifier None Typical Low $125.89 Median $158.49 Typical High $204.17 | Professional | None | $125.89 | $158.49 | $204.17 |
Sentara Setting Facility Modifier None Typical Low $109.65 Median $616.60 Typical High $2,951.21 | Facility | None | $109.65 | $616.60 | $2,951.21 |
Sentara Setting Professional Modifier None Typical Low $162.18 Median $213.80 Typical High $416.87 | Professional | None | $162.18 | $213.80 | $416.87 |
United Setting Facility Modifier None Typical Low $323.59 Median $1,445.44 Typical High $3,630.78 | Facility | None | $323.59 | $1,445.44 | $3,630.78 |
United Setting Professional Modifier None Typical Low $83.18 Median $144.54 Typical High $281.84 | Professional | None | $83.18 | $144.54 | $281.84 |
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 $56.23 Median $75.86 Typical High $97.72 | Professional | 52 · Reduced service | $56.23 | $75.86 | $97.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $30.20 Typical High $38.90 | Professional | 53 · Discontinued | $22.39 | $30.20 | $38.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $112.20 Typical High $144.54 | Professional | 54 · Surgery only | $83.18 | $112.20 | $144.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $22.39 Typical High $28.84 | Professional | 55 · Aftercare only | $16.98 | $22.39 | $28.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $15.14 Typical High $19.50 | Professional | 56 · Pre-op care only | $11.22 | $15.14 | $19.50 |
Where Virginia sits
The same service costs 6.3 times more in New York 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
NY $2,712MT $427
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.