How much rates vary
Facilitymedian $2,754 · 10th to 90th $178 to $9,550Professionalmedian $158 · 10th to 90th $123 to $257
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 $169.82 Median $4,073.80 Typical High $9,332.54 | Facility | None | $169.82 | $4,073.80 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $117.49 Median $169.82 Typical High $2,137.96 | Professional | None | $117.49 | $169.82 | $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 $125.89 Median $151.36 Typical High $177.83 | Professional | None | $125.89 | $151.36 | $177.83 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $186.21 Median $223.87 Typical High $263.03 | Professional | 50 · Both sides | $186.21 | $223.87 | $263.03 |
CareFirst Setting Professional Modifier None Typical Low $125.89 Median $141.25 Typical High $165.96 | Professional | None | $125.89 | $141.25 | $165.96 |
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 $125.89 Median $165.96 Typical High $245.47 | Professional | None | $125.89 | $165.96 | $245.47 |
Kaiser Permanente Setting Professional Modifier None Typical Low $114.82 Median $131.83 Typical High $162.18 | Professional | None | $114.82 | $131.83 | $162.18 |
Medcost Setting Professional Modifier None Typical Low $251.19 Median $251.19 Typical High $257.04 | Professional | None | $251.19 | $251.19 | $257.04 |
Medcost Setting Facility Modifier None Typical Low $117.49 Median $245.47 Typical High $245.47 | Facility | None | $117.49 | $245.47 | $245.47 |
Medcost Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $245.47 | Professional | None | $245.47 | $245.47 | $245.47 |
Sentara Setting Facility Modifier None Typical Low $141.25 Median $851.14 Typical High $8,709.64 | Facility | None | $141.25 | $851.14 | $8,709.64 |
Sentara Setting Professional Modifier None Typical Low $147.91 Median $213.80 Typical High $4,570.88 | Professional | None | $147.91 | $213.80 | $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 $102.33 Median $162.18 Typical High $275.42 | Professional | None | $102.33 | $162.18 | $275.42 |
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 $58.88 Median $85.11 Typical High $85.11 | Professional | 52 · Reduced service | $58.88 | $85.11 | $85.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $33.88 Typical High $33.88 | Professional | 53 · Discontinued | $23.44 | $33.88 | $33.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $87.10 Median $128.82 Typical High $128.82 | Professional | 54 · Surgery only | $87.10 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $25.70 Typical High $25.70 | Professional | 55 · Aftercare only | $17.78 | $25.70 | $25.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $16.98 Typical High $16.98 | Professional | 56 · Pre-op care only | $11.75 | $16.98 | $16.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $81.28 Median $120.23 Typical High $120.23 | Professional | 78 · Unplanned return to OR | $81.28 | $120.23 | $120.23 |
Where Virginia sits
The same service costs 11.0 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 $4,556MT $413
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.