How much rates vary
Facilitymedian $3,090 · 10th to 90th $724 to $9,550Professionalmedian $813 · 10th to 90th $631 to $1,148
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 $758.58 Median $5,248.07 Typical High $10,000.00 | Facility | None | $758.58 | $5,248.07 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $676.08 Median $794.33 Typical High $1,479.11 | Professional | None | $676.08 | $794.33 | $1,479.11 |
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 $630.96 Median $812.83 Typical High $1,096.48 | Professional | None | $630.96 | $812.83 | $1,096.48 |
CareFirst Setting Professional Modifier None Typical Low $630.96 Median $707.95 Typical High $831.76 | Professional | None | $630.96 | $707.95 | $831.76 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $1,258.93 Typical High $2,570.40 | Facility | None | $524.81 | $1,258.93 | $2,570.40 |
Cigna Setting Professional Modifier None Typical Low $645.65 Median $812.83 Typical High $1,148.15 | Professional | None | $645.65 | $812.83 | $1,148.15 |
Kaiser Permanente Setting Professional Modifier None Typical Low $794.33 Median $1,047.13 Typical High $1,230.27 | Professional | None | $794.33 | $1,047.13 | $1,230.27 |
Medcost Setting Professional Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $1,122.02 | Professional | None | $1,023.29 | $1,023.29 | $1,122.02 |
Medcost Setting Facility Modifier None Typical Low $758.58 Median $933.25 Typical High $1,513.56 | Facility | None | $758.58 | $933.25 | $1,513.56 |
Medcost Setting Professional Modifier None Typical Low $3,890.45 Median $3,890.45 Typical High $3,890.45 | Professional | None | $3,890.45 | $3,890.45 | $3,890.45 |
Sentara Setting Facility Modifier None Typical Low $549.54 Median $1,778.28 Typical High $8,709.64 | Facility | None | $549.54 | $1,778.28 | $8,709.64 |
Sentara Setting Professional Modifier None Typical Low $645.65 Median $1,000.00 Typical High $5,128.61 | Professional | None | $645.65 | $1,000.00 | $5,128.61 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $4,897.79 Typical High $13,182.57 | Facility | None | $1,230.27 | $4,897.79 | $13,182.57 |
United Setting Professional Modifier None Typical Low $549.54 Median $794.33 Typical High $1,348.96 | Professional | None | $549.54 | $794.33 | $1,348.96 |
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 $338.84 Median $380.19 Typical High $467.74 | Professional | 52 · Reduced service | $338.84 | $380.19 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $151.36 Typical High $186.21 | Professional | 53 · Discontinued | $138.04 | $151.36 | $186.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $562.34 Typical High $691.83 | Professional | 54 · Surgery only | $512.86 | $562.34 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $112.20 Typical High $141.25 | Professional | 55 · Aftercare only | $102.33 | $112.20 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $75.86 Typical High $93.33 | Professional | 56 · Pre-op care only | $67.61 | $75.86 | $93.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $524.81 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $478.63 | $524.81 | $645.65 |
Where Virginia sits
The same service costs 3.1 times more in Alaska 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
AK $5,990MD $1,938
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.