How much rates vary
Facilitymedian $2,570 · 10th to 90th $331 to $9,550Professionalmedian $282 · 10th to 90th $229 to $398
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 $316.23 Median $4,073.80 Typical High $10,000.00 | Facility | None | $316.23 | $4,073.80 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $229.09 Median $316.23 Typical High $2,041.74 | Professional | None | $229.09 | $316.23 | $2,041.74 |
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 $239.88 Median $281.84 Typical High $331.13 | Professional | None | $239.88 | $281.84 | $331.13 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $354.81 Median $426.58 Typical High $501.19 | Professional | 50 · Both sides | $354.81 | $426.58 | $501.19 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $147.91 Median $177.83 Typical High $208.93 | Professional | 62 · Two surgeons | $147.91 | $177.83 | $208.93 |
CareFirst Setting Professional Modifier None Typical Low $257.04 Median $281.84 Typical High $331.13 | Professional | None | $257.04 | $281.84 | $331.13 |
Cigna Setting Facility Modifier None Typical Low $346.74 Median $1,122.02 Typical High $2,089.30 | Facility | None | $346.74 | $1,122.02 | $2,089.30 |
Cigna Setting Professional Modifier None Typical Low $234.42 Median $251.19 Typical High $363.08 | Professional | None | $234.42 | $251.19 | $363.08 |
Kaiser Permanente Setting Professional Modifier None Typical Low $204.17 Median $223.87 Typical High $281.84 | Professional | None | $204.17 | $223.87 | $281.84 |
Medcost Setting Professional Modifier None Typical Low $346.74 Median $346.74 Typical High $549.54 | Professional | None | $346.74 | $346.74 | $549.54 |
Medcost Setting Facility Modifier None Typical Low $229.09 Median $338.84 Typical High $478.63 | Facility | None | $229.09 | $338.84 | $478.63 |
Medcost Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $331.13 | Professional | None | $331.13 | $331.13 | $331.13 |
Sentara Setting Facility Modifier None Typical Low $234.42 Median $977.24 Typical High $8,709.64 | Facility | None | $234.42 | $977.24 | $8,709.64 |
Sentara Setting Professional Modifier None Typical Low $234.42 Median $316.23 Typical High $4,073.80 | Professional | None | $234.42 | $316.23 | $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 $190.55 Median $263.03 Typical High $436.52 | Professional | None | $190.55 | $263.03 | $436.52 |
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 $114.82 Median $158.49 Typical High $158.49 | Professional | 52 · Reduced service | $114.82 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $64.57 Typical High $64.57 | Professional | 53 · Discontinued | $45.71 | $64.57 | $64.57 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $169.82 Median $239.88 Typical High $239.88 | Professional | 54 · Surgery only | $169.82 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $47.86 Typical High $47.86 | Professional | 55 · Aftercare only | $33.88 | $47.86 | $47.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $31.62 Typical High $31.62 | Professional | 56 · Pre-op care only | $22.91 | $31.62 | $31.62 |
Where Virginia sits
The same service costs 6.4 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 $4,783MT $743
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.