How much rates vary
Facilitymedian $794 · 10th to 90th $182 to $4,074Professionalmedian $398 · 10th to 90th $257 to $589
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 $446.68 Median $3,981.07 Typical High $9,332.54 | Facility | None | $446.68 | $3,981.07 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $281.84 Median $426.58 Typical High $660.69 | Professional | None | $281.84 | $426.58 | $660.69 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,698.24 Median $2,398.83 Typical High $2,951.21 | Facility | None | $1,698.24 | $2,398.83 | $2,951.21 |
Anthem BCBS Setting Professional Modifier None Typical Low $263.03 Median $389.05 Typical High $549.54 | Professional | None | $263.03 | $389.05 | $549.54 |
CareFirst Setting Professional Modifier None Typical Low $223.87 Median $245.47 Typical High $295.12 | Professional | None | $223.87 | $245.47 | $295.12 |
Cigna Setting Facility Modifier None Typical Low $416.87 Median $602.56 Typical High $2,187.76 | Facility | None | $416.87 | $602.56 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $275.42 Median $416.87 Typical High $562.34 | Professional | None | $275.42 | $416.87 | $562.34 |
Kaiser Permanente Setting Professional Modifier None Typical Low $436.52 Median $575.44 Typical High $676.08 | Professional | None | $436.52 | $575.44 | $676.08 |
Medcost Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $616.60 | Professional | None | $512.86 | $512.86 | $616.60 |
Medcost Setting Facility Modifier None Typical Low $316.23 Median $467.74 Typical High $776.25 | Facility | None | $316.23 | $467.74 | $776.25 |
Medcost Setting Professional Modifier None Typical Low $1,995.26 Median $1,995.26 Typical High $1,995.26 | Professional | None | $1,995.26 | $1,995.26 | $1,995.26 |
Sentara Setting Facility Modifier None Typical Low $245.47 Median $489.78 Typical High $2,454.71 | Facility | None | $245.47 | $489.78 | $2,454.71 |
Sentara Setting Professional Modifier None Typical Low $323.59 Median $501.19 Typical High $1,479.11 | Professional | None | $323.59 | $501.19 | $1,479.11 |
United Setting Facility Modifier None Typical Low $100.00 Median $660.69 Typical High $2,089.30 | Facility | None | $100.00 | $660.69 | $2,089.30 |
United Setting Professional Modifier None Typical Low $234.42 Median $389.05 Typical High $645.65 | Professional | None | $234.42 | $389.05 | $645.65 |
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 $141.25 Median $169.82 Typical High $234.42 | Professional | 52 · Reduced service | $141.25 | $169.82 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $67.61 Typical High $95.50 | Professional | 53 · Discontinued | $56.23 | $67.61 | $95.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $213.80 Median $257.04 Typical High $354.81 | Professional | 54 · Surgery only | $213.80 | $257.04 | $354.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $51.29 Typical High $70.79 | Professional | 55 · Aftercare only | $42.66 | $51.29 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $34.67 Typical High $46.77 | Professional | 56 · Pre-op care only | $28.18 | $34.67 | $46.77 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $199.53 Median $239.88 Typical High $331.13 | Professional | 78 · Unplanned return to OR | $199.53 | $239.88 | $331.13 |
Where Virginia sits
The same service costs 4.1 times more in New York than in Maryland. 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
NY $3,010MD $740
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.