How much rates vary
Facilitymedian $1,413 · 10th to 90th $129 to $5,012Professionalmedian $123 · 10th to 90th $93 to $195
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 $128.82 Median $4,073.80 Typical High $9,332.54 | Facility | None | $128.82 | $4,073.80 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $89.13 Median $128.82 Typical High $186.21 | Professional | None | $89.13 | $128.82 | $186.21 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,884.03 Median $3,715.35 Typical High $4,265.80 | Facility | None | $2,884.03 | $3,715.35 | $4,265.80 |
Anthem BCBS Setting Professional Modifier None Typical Low $95.50 Median $114.82 Typical High $134.90 | Professional | None | $95.50 | $114.82 | $134.90 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $141.25 Median $169.82 Typical High $199.53 | Professional | 50 · Both sides | $141.25 | $169.82 | $199.53 |
CareFirst Setting Professional Modifier None Typical Low $102.33 Median $112.20 Typical High $131.83 | Professional | None | $102.33 | $112.20 | $131.83 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $1,148.15 Typical High $2,187.76 | Facility | None | $478.63 | $1,148.15 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $93.33 Median $128.82 Typical High $186.21 | Professional | None | $93.33 | $128.82 | $186.21 |
Kaiser Permanente Setting Professional Modifier None Typical Low $138.04 Median $162.18 Typical High $204.17 | Professional | None | $138.04 | $162.18 | $204.17 |
Medcost Setting Professional Modifier None Typical Low $169.82 Median $169.82 Typical High $208.93 | Professional | None | $169.82 | $169.82 | $208.93 |
Medcost Setting Facility Modifier None Typical Low $89.13 Median $128.82 Typical High $263.03 | Facility | None | $89.13 | $128.82 | $263.03 |
Medcost Setting Professional Modifier None Typical Low $169.82 Median $169.82 Typical High $169.82 | Professional | None | $169.82 | $169.82 | $169.82 |
Sentara Setting Facility Modifier None Typical Low $91.20 Median $616.60 Typical High $3,311.31 | Facility | None | $91.20 | $616.60 | $3,311.31 |
Sentara Setting Professional Modifier None Typical Low $112.20 Median $169.82 Typical High $1,737.80 | Professional | None | $112.20 | $169.82 | $1,737.80 |
United Setting Facility Modifier None Typical Low $323.59 Median $1,445.44 Typical High $3,981.07 | Facility | None | $323.59 | $1,445.44 | $3,981.07 |
United Setting Professional Modifier None Typical Low $79.43 Median $123.03 Typical High $218.78 | Professional | None | $79.43 | $123.03 | $218.78 |
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 $44.67 Median $64.57 Typical High $91.20 | Professional | 52 · Reduced service | $44.67 | $64.57 | $91.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.78 Median $25.70 Typical High $37.15 | Professional | 53 · Discontinued | $17.78 | $25.70 | $37.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $67.61 Median $95.50 Typical High $138.04 | Professional | 54 · Surgery only | $67.61 | $95.50 | $138.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $19.05 Typical High $27.54 | Professional | 55 · Aftercare only | $13.49 | $19.05 | $27.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.91 Median $12.88 Typical High $18.62 | Professional | 56 · Pre-op care only | $8.91 | $12.88 | $18.62 |
Where Virginia sits
The same service costs 10.9 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 $3,950MT $363
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.