How much rates vary
Facilitymedian $9,120 · 10th to 90th $871 to $25,704Professionalmedian $759 · 10th to 90th $617 to $1,349
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 $891.25 Median $7,079.46 Typical High $22,908.68 | Facility | None | $891.25 | $7,079.46 | $22,908.68 |
Aetna Setting Professional Modifier None Typical Low $616.60 Median $724.44 Typical High $7,079.46 | Professional | None | $616.60 | $724.44 | $7,079.46 |
Anthem BCBS Setting Facility Modifier None Typical Low $15,135.61 Median $20,892.96 Typical High $23,988.33 | Facility | None | $15,135.61 | $20,892.96 | $23,988.33 |
Anthem BCBS Setting Professional Modifier None Typical Low $602.56 Median $724.44 Typical High $912.01 | Professional | None | $602.56 | $724.44 | $912.01 |
CareFirst Setting Professional Modifier None Typical Low $630.96 Median $707.95 Typical High $851.14 | Professional | None | $630.96 | $707.95 | $851.14 |
Cigna Setting Facility Modifier None Typical Low $7,585.78 Median $12,882.50 Typical High $41,686.94 | Facility | None | $7,585.78 | $12,882.50 | $41,686.94 |
Cigna Setting Professional Modifier None Typical Low $616.60 Median $870.96 Typical High $1,348.96 | Professional | None | $616.60 | $870.96 | $1,348.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $602.56 Median $724.44 Typical High $891.25 | Professional | None | $602.56 | $724.44 | $891.25 |
Medcost Setting Facility Modifier None Typical Low $724.44 Median $891.25 Typical High $1,230.27 | Facility | None | $724.44 | $891.25 | $1,230.27 |
Medcost Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $758.58 | Professional | None | $758.58 | $758.58 | $758.58 |
Sentara Setting Facility Modifier None Typical Low $645.65 Median $1,621.81 Typical High $17,782.79 | Facility | None | $645.65 | $1,621.81 | $17,782.79 |
Sentara Setting Professional Modifier None Typical Low $645.65 Median $891.25 Typical High $16,982.44 | Professional | None | $645.65 | $891.25 | $16,982.44 |
United Setting Facility Modifier None Typical Low $2,570.40 Median $10,964.78 Typical High $33,884.42 | Facility | None | $2,570.40 | $10,964.78 | $33,884.42 |
United Setting Professional Modifier None Typical Low $588.84 Median $954.99 Typical High $1,412.54 | Professional | None | $588.84 | $954.99 | $1,412.54 |
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 $309.03 Median $363.08 Typical High $363.08 | Professional | 52 · Reduced service | $309.03 | $363.08 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $144.54 Typical High $144.54 | Professional | 53 · Discontinued | $123.03 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $537.03 Typical High $537.03 | Professional | 54 · Surgery only | $457.09 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $107.15 Typical High $107.15 | Professional | 55 · Aftercare only | $91.20 | $107.15 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $72.44 Typical High $72.44 | Professional | 56 · Pre-op care only | $61.66 | $72.44 | $72.44 |
Where Virginia sits
The same service costs 9.6 times more in Oklahoma 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
OK $19,472MT $2,030
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.