How much rates vary
Facilitymedian $2,570 · 10th to 90th $447 to $9,550Professionalmedian $389 · 10th to 90th $309 to $575
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 $389.05 Median $3,801.89 Typical High $9,332.54 | Facility | None | $389.05 | $3,801.89 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $316.23 Median $467.74 Typical High $2,137.96 | Professional | None | $316.23 | $467.74 | $2,137.96 |
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 $338.84 Median $407.38 Typical High $478.63 | Professional | None | $338.84 | $407.38 | $478.63 |
CareFirst Setting Professional Modifier None Typical Low $346.74 Median $380.19 Typical High $446.68 | Professional | None | $346.74 | $380.19 | $446.68 |
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 $331.13 Median $354.81 Typical High $512.86 | Professional | None | $331.13 | $354.81 | $512.86 |
Kaiser Permanente Setting Professional Modifier None Typical Low $316.23 Median $354.81 Typical High $446.68 | Professional | None | $316.23 | $354.81 | $446.68 |
Medcost Setting Professional Modifier None Typical Low $398.11 Median $478.63 Typical High $478.63 | Professional | None | $398.11 | $478.63 | $478.63 |
Medcost Setting Facility Modifier None Typical Low $316.23 Median $436.52 Typical High $676.08 | Facility | None | $316.23 | $436.52 | $676.08 |
Medcost Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $436.52 | Professional | None | $436.52 | $436.52 | $436.52 |
Sentara Setting Facility Modifier None Typical Low $281.84 Median $1,380.38 Typical High $8,709.64 | Facility | None | $281.84 | $1,380.38 | $8,709.64 |
Sentara Setting Professional Modifier None Typical Low $281.84 Median $426.58 Typical High $4,073.80 | Professional | None | $281.84 | $426.58 | $4,073.80 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $5,011.87 Typical High $13,182.57 | Facility | None | $1,230.27 | $5,011.87 | $13,182.57 |
United Setting Professional Modifier None Typical Low $263.03 Median $346.74 Typical High $602.56 | Professional | None | $263.03 | $346.74 | $602.56 |
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 $158.49 Median $234.42 Typical High $234.42 | Professional | 52 · Reduced service | $158.49 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $93.33 Typical High $93.33 | Professional | 53 · Discontinued | $63.10 | $93.33 | $93.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $346.74 Typical High $346.74 | Professional | 54 · Surgery only | $239.88 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $70.79 Typical High $70.79 | Professional | 55 · Aftercare only | $47.86 | $70.79 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $46.77 Typical High $46.77 | Professional | 56 · Pre-op care only | $31.62 | $46.77 | $46.77 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $223.87 Median $323.59 Typical High $323.59 | Professional | 78 · Unplanned return to OR | $223.87 | $323.59 | $323.59 |
Where Virginia sits
The same service costs 4.5 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 $4,914MT $1,099
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.