How much rates vary
Facilitymedian $1,288 · 10th to 90th $126 to $4,786Professionalmedian $85 · 10th to 90th $69 to $145
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 $89.13 Median $4,073.80 Typical High $10,000.00 | Facility | None | $89.13 | $4,073.80 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $75.86 Median $89.13 Typical High $158.49 | Professional | None | $75.86 | $89.13 | $158.49 |
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 $70.79 Median $85.11 Typical High $102.33 | Professional | None | $70.79 | $85.11 | $102.33 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $107.15 Median $128.82 Typical High $154.88 | Professional | 50 · Both sides | $107.15 | $128.82 | $154.88 |
CareFirst Setting Professional Modifier None Typical Low $74.13 Median $81.28 Typical High $107.15 | Professional | None | $74.13 | $81.28 | $107.15 |
Cigna Setting Facility Modifier None Typical Low $346.74 Median $707.95 Typical High $1,659.59 | Facility | None | $346.74 | $707.95 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $69.18 Median $77.62 Typical High $177.83 | Professional | None | $69.18 | $77.62 | $177.83 |
Kaiser Permanente Setting Professional Modifier None Typical Low $70.79 Median $85.11 Typical High $104.71 | Professional | None | $70.79 | $85.11 | $104.71 |
Medcost Setting Professional Modifier None Typical Low $223.87 Median $302.00 Typical High $302.00 | Professional | None | $223.87 | $302.00 | $302.00 |
Medcost Setting Facility Modifier None Typical Low $89.13 Median $125.89 Typical High $147.91 | Facility | None | $89.13 | $125.89 | $147.91 |
Medcost Setting Professional Modifier None Typical Low $53.70 Median $61.66 Typical High $109.65 | Professional | None | $53.70 | $61.66 | $109.65 |
Sentara Setting Facility Modifier None Typical Low $83.18 Median $616.60 Typical High $2,951.21 | Facility | None | $83.18 | $616.60 | $2,951.21 |
Sentara Setting Professional Modifier None Typical Low $77.62 Median $112.20 Typical High $218.78 | Professional | None | $77.62 | $112.20 | $218.78 |
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 $44.67 Median $81.28 Typical High $186.21 | Professional | None | $44.67 | $81.28 | $186.21 |
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 $38.02 Median $44.67 Typical High $44.67 | Professional | 52 · Reduced service | $38.02 | $44.67 | $44.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.14 Median $17.78 Typical High $17.78 | Professional | 53 · Discontinued | $15.14 | $17.78 | $17.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $57.54 Median $67.61 Typical High $67.61 | Professional | 54 · Surgery only | $57.54 | $67.61 | $67.61 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.48 Median $13.49 Typical High $13.49 | Professional | 55 · Aftercare only | $11.48 | $13.49 | $13.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $8.91 Typical High $8.91 | Professional | 56 · Pre-op care only | $7.59 | $8.91 | $8.91 |
Where Virginia sits
The same service costs 12.2 times more in Connecticut 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
CT $2,815MT $231
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.