How much rates vary
Facilitymedian $2,754 · 10th to 90th $240 to $9,550Professionalmedian $229 · 10th to 90th $162 to $437
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 $275.42 Median $4,073.80 Typical High $9,332.54 | Facility | None | $275.42 | $4,073.80 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $158.49 Median $275.42 Typical High $436.52 | Professional | None | $158.49 | $275.42 | $436.52 |
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 $169.82 Median $204.17 Typical High $239.88 | Professional | None | $169.82 | $204.17 | $239.88 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $257.04 Median $302.00 Typical High $363.08 | Professional | 50 · Both sides | $257.04 | $302.00 | $363.08 |
CareFirst Setting Professional Modifier None Typical Low $169.82 Median $190.55 Typical High $223.87 | Professional | None | $169.82 | $190.55 | $223.87 |
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 $162.18 Median $281.84 Typical High $398.11 | Professional | None | $162.18 | $281.84 | $398.11 |
Kaiser Permanente Setting Professional Modifier None Typical Low $323.59 Median $380.19 Typical High $478.63 | Professional | None | $323.59 | $380.19 | $478.63 |
Medcost Setting Professional Modifier None Typical Low $416.87 Median $416.87 Typical High $426.58 | Professional | None | $416.87 | $416.87 | $426.58 |
Medcost Setting Facility Modifier None Typical Low $158.49 Median $275.42 Typical High $575.44 | Facility | None | $158.49 | $275.42 | $575.44 |
Medcost Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $354.81 | Professional | None | $354.81 | $354.81 | $354.81 |
Sentara Setting Facility Modifier None Typical Low $162.18 Median $912.01 Typical High $8,709.64 | Facility | None | $162.18 | $912.01 | $8,709.64 |
Sentara Setting Professional Modifier None Typical Low $309.03 Median $380.19 Typical High $4,570.88 | Professional | None | $309.03 | $380.19 | $4,570.88 |
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 $138.04 Median $251.19 Typical High $457.09 | Professional | None | $138.04 | $251.19 | $457.09 |
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 $79.43 Median $138.04 Typical High $218.78 | Professional | 52 · Reduced service | $79.43 | $138.04 | $218.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $54.95 Typical High $87.10 | Professional | 53 · Discontinued | $31.62 | $54.95 | $87.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $204.17 Typical High $331.13 | Professional | 54 · Surgery only | $120.23 | $204.17 | $331.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $40.74 Typical High $66.07 | Professional | 55 · Aftercare only | $23.99 | $40.74 | $66.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $27.54 Typical High $43.65 | Professional | 56 · Pre-op care only | $15.85 | $27.54 | $43.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $112.20 Median $190.55 Typical High $309.03 | Professional | 78 · Unplanned return to OR | $112.20 | $190.55 | $309.03 |
Where Virginia sits
The same service costs 6.3 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 $4,654MT $736
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.