How much rates vary
Facilitymedian $2,692 · 10th to 90th $417 to $9,550Professionalmedian $479 · 10th to 90th $316 to $692
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 $549.54 Median $3,981.07 Typical High $9,332.54 | Facility | None | $549.54 | $3,981.07 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $338.84 Median $537.03 Typical High $933.25 | Professional | None | $338.84 | $537.03 | $933.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,677.35 Median $6,456.54 Typical High $7,244.36 | Facility | None | $4,677.35 | $6,456.54 | $7,244.36 |
Anthem BCBS Setting Professional Modifier None Typical Low $316.23 Median $457.09 Typical High $645.65 | Professional | None | $316.23 | $457.09 | $645.65 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $467.74 Median $676.08 Typical High $977.24 | Professional | 50 · Both sides | $467.74 | $676.08 | $977.24 |
CareFirst Setting Professional Modifier None Typical Low $323.59 Median $354.81 Typical High $426.58 | Professional | None | $323.59 | $354.81 | $426.58 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $1,288.25 Typical High $2,344.23 | Facility | None | $478.63 | $1,288.25 | $2,344.23 |
Cigna Setting Professional Modifier None Typical Low $323.59 Median $489.78 Typical High $676.08 | Professional | None | $323.59 | $489.78 | $676.08 |
Kaiser Permanente Setting Professional Modifier None Typical Low $524.81 Median $691.83 Typical High $812.83 | Professional | None | $524.81 | $691.83 | $812.83 |
Medcost Setting Professional Modifier None Typical Low $588.84 Median $588.84 Typical High $660.69 | Professional | None | $588.84 | $588.84 | $660.69 |
Medcost Setting Facility Modifier None Typical Low $363.08 Median $549.54 Typical High $912.01 | Facility | None | $363.08 | $549.54 | $912.01 |
Medcost Setting Professional Modifier None Typical Low $977.24 Median $977.24 Typical High $977.24 | Professional | None | $977.24 | $977.24 | $977.24 |
Sentara Setting Facility Modifier None Typical Low $251.19 Median $1,445.44 Typical High $8,709.64 | Facility | None | $251.19 | $1,445.44 | $8,709.64 |
Sentara Setting Professional Modifier None Typical Low $363.08 Median $575.44 Typical High $5,128.61 | Professional | None | $363.08 | $575.44 | $5,128.61 |
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 $269.15 Median $457.09 Typical High $758.58 | Professional | None | $269.15 | $457.09 | $758.58 |
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 $169.82 Median $204.17 Typical High $275.42 | Professional | 52 · Reduced service | $169.82 | $204.17 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $81.28 Typical High $112.20 | Professional | 53 · Discontinued | $67.61 | $81.28 | $112.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $302.00 Typical High $416.87 | Professional | 54 · Surgery only | $257.04 | $302.00 | $416.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $60.26 Typical High $83.18 | Professional | 55 · Aftercare only | $51.29 | $60.26 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $40.74 Typical High $54.95 | Professional | 56 · Pre-op care only | $33.88 | $40.74 | $54.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $239.88 Median $281.84 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $239.88 | $281.84 | $389.05 |
Where Virginia sits
The same service costs 5.3 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 $6,438MT $1,226
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.