How much rates vary
Facilitymedian $6,761 · 10th to 90th $389 to $30,903Professionalmedian $363 · 10th to 90th $229 to $2,239
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 $1,047.13 Median $4,786.30 Typical High $14,125.38 | Facility | None | $1,047.13 | $4,786.30 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $323.59 Median $512.86 Typical High $2,344.23 | Professional | None | $323.59 | $512.86 | $2,344.23 |
Anthem BCBS Setting Facility Modifier None Typical Low $48,977.88 Median $63,095.73 Typical High $67,608.30 | Facility | None | $48,977.88 | $63,095.73 | $67,608.30 |
Anthem BCBS Setting Professional Modifier None Typical Low $302.00 Median $363.08 Typical High $436.52 | Professional | None | $302.00 | $363.08 | $436.52 |
CareFirst Setting Professional Modifier None Typical Low $309.03 Median $338.84 Typical High $446.68 | Professional | None | $309.03 | $338.84 | $446.68 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $5,754.40 Typical High $10,964.78 | Facility | None | $512.86 | $5,754.40 | $10,964.78 |
Cigna Setting Professional Modifier None Typical Low $181.97 Median $331.13 Typical High $2,238.72 | Professional | None | $181.97 | $331.13 | $2,238.72 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,089.30 Median $2,630.27 Typical High $3,235.94 | Professional | None | $2,089.30 | $2,630.27 | $3,235.94 |
Medcost Setting Professional Modifier None Typical Low $269.15 Median $338.84 Typical High $338.84 | Professional | None | $269.15 | $338.84 | $338.84 |
Medcost Setting Facility Modifier None Typical Low $208.93 Median $281.84 Typical High $2,818.38 | Facility | None | $208.93 | $281.84 | $2,818.38 |
Medcost Setting Professional Modifier None Typical Low $117.49 Median $186.21 Typical High $257.04 | Professional | None | $117.49 | $186.21 | $257.04 |
Sentara Setting Facility Modifier None Typical Low $165.96 Median $1,548.82 Typical High $11,481.54 | Facility | None | $165.96 | $1,548.82 | $11,481.54 |
Sentara Setting Professional Modifier None Typical Low $218.78 Median $281.84 Typical High $5,370.32 | Professional | None | $218.78 | $281.84 | $5,370.32 |
United Setting Facility Modifier None Typical Low $2,630.27 Median $10,471.29 Typical High $37,153.52 | Facility | None | $2,630.27 | $10,471.29 | $37,153.52 |
United Setting Professional Modifier None Typical Low $169.82 Median $331.13 Typical High $2,454.71 | Professional | None | $169.82 | $331.13 | $2,454.71 |
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 $162.18 Median $234.42 Typical High $1,174.90 | Professional | 52 · Reduced service | $162.18 | $234.42 | $1,174.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $93.33 Typical High $467.74 | Professional | 53 · Discontinued | $64.57 | $93.33 | $467.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $346.74 Typical High $1,778.28 | Professional | 54 · Surgery only | $245.47 | $346.74 | $1,778.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $69.18 Typical High $354.81 | Professional | 55 · Aftercare only | $48.98 | $69.18 | $354.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $46.77 Typical High $234.42 | Professional | 56 · Pre-op care only | $32.36 | $46.77 | $234.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $323.59 Typical High $1,659.59 | Professional | 78 · Unplanned return to OR | $229.09 | $323.59 | $1,659.59 |
Where Virginia sits
The same service costs 13.1 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 $15,603MT $1,192
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.