How much rates vary
Facilitymedian $955 · 10th to 90th $174 to $4,365Professionalmedian $158 · 10th to 90th $120 to $380
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 $177.83 Median $602.56 Typical High $8,317.64 | Facility | None | $177.83 | $602.56 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $128.82 Median $269.15 Typical High $389.05 | Professional | None | $128.82 | $269.15 | $389.05 |
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 $120.23 Median $144.54 Typical High $173.78 | Professional | None | $120.23 | $144.54 | $173.78 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $181.97 Median $218.78 Typical High $263.03 | Professional | 50 · Both sides | $181.97 | $218.78 | $263.03 |
CareFirst Setting Professional Modifier None Typical Low $128.82 Median $144.54 Typical High $190.55 | Professional | None | $128.82 | $144.54 | $190.55 |
Cigna Setting Facility Modifier None Typical Low $346.74 Median $602.56 Typical High $1,621.81 | Facility | None | $346.74 | $602.56 | $1,621.81 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $229.09 Typical High $389.05 | Professional | None | $120.23 | $229.09 | $389.05 |
Kaiser Permanente Setting Professional Modifier None Typical Low $281.84 Median $338.84 Typical High $426.58 | Professional | None | $281.84 | $338.84 | $426.58 |
Medcost Setting Professional Modifier None Typical Low $446.68 Median $588.84 Typical High $588.84 | Professional | None | $446.68 | $588.84 | $588.84 |
Medcost Setting Facility Modifier None Typical Low $147.91 Median $239.88 Typical High $446.68 | Facility | None | $147.91 | $239.88 | $446.68 |
Medcost Setting Professional Modifier None Typical Low $251.19 Median $323.59 Typical High $338.84 | Professional | None | $251.19 | $323.59 | $338.84 |
Sentara Setting Facility Modifier None Typical Low $117.49 Median $616.60 Typical High $2,951.21 | Facility | None | $117.49 | $616.60 | $2,951.21 |
Sentara Setting Professional Modifier None Typical Low $257.04 Median $354.81 Typical High $630.96 | Professional | None | $257.04 | $354.81 | $630.96 |
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 $95.50 Median $194.98 Typical High $446.68 | Professional | None | $95.50 | $194.98 | $446.68 |
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 $64.57 Median $100.00 Typical High $141.25 | Professional | 52 · Reduced service | $64.57 | $100.00 | $141.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $39.81 Typical High $56.23 | Professional | 53 · Discontinued | $26.30 | $39.81 | $56.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $97.72 Median $147.91 Typical High $208.93 | Professional | 54 · Surgery only | $97.72 | $147.91 | $208.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $29.51 Typical High $41.69 | Professional | 55 · Aftercare only | $19.50 | $29.51 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $19.95 Typical High $28.18 | Professional | 56 · Pre-op care only | $12.88 | $19.95 | $28.18 |
Where Virginia sits
The same service costs 4.6 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 $2,775MT $606
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.