How much rates vary
Facilitymedian $3,631 · 10th to 90th $832 to $10,233Professionalmedian $794 · 10th to 90th $631 to $1,122
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 $794.33 Median $7,762.47 Typical High $15,488.17 | Facility | None | $794.33 | $7,762.47 | $15,488.17 |
Aetna Setting Professional Modifier None Typical Low $758.58 Median $794.33 Typical High $1,148.15 | Professional | None | $758.58 | $794.33 | $1,148.15 |
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 $676.08 Median $812.83 Typical High $977.24 | Professional | None | $676.08 | $812.83 | $977.24 |
CareFirst Setting Professional Modifier None Typical Low $707.95 Median $794.33 Typical High $1,023.29 | Professional | None | $707.95 | $794.33 | $1,023.29 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $1,905.46 Typical High $3,548.13 | Facility | None | $1,000.00 | $1,905.46 | $3,548.13 |
Cigna Setting Professional Modifier None Typical Low $691.83 Median $724.44 Typical High $1,148.15 | Professional | None | $691.83 | $724.44 | $1,148.15 |
Kaiser Permanente Setting Professional Modifier None Typical Low $630.96 Median $758.58 Typical High $933.25 | Professional | None | $630.96 | $758.58 | $933.25 |
Medcost Setting Professional Modifier None Typical Low $851.14 Median $1,148.15 Typical High $1,148.15 | Professional | None | $851.14 | $1,148.15 | $1,148.15 |
Medcost Setting Facility Modifier None Typical Low $794.33 Median $954.99 Typical High $1,318.26 | Facility | None | $794.33 | $954.99 | $1,318.26 |
Medcost Setting Professional Modifier None Typical Low $794.33 Median $870.96 Typical High $912.01 | Professional | None | $794.33 | $870.96 | $912.01 |
Sentara Setting Facility Modifier None Typical Low $575.44 Median $1,778.28 Typical High $8,709.64 | Facility | None | $575.44 | $1,778.28 | $8,709.64 |
Sentara Setting Professional Modifier None Typical Low $575.44 Median $870.96 Typical High $1,698.24 | Professional | None | $575.44 | $870.96 | $1,698.24 |
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 $489.78 Median $660.69 Typical High $1,288.25 | Professional | None | $489.78 | $660.69 | $1,288.25 |
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 $380.19 Median $398.11 Typical High $398.11 | Professional | 52 · Reduced service | $380.19 | $398.11 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $162.18 Typical High $162.18 | Professional | 53 · Discontinued | $151.36 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $602.56 Typical High $602.56 | Professional | 54 · Surgery only | $562.34 | $602.56 | $602.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $120.23 Typical High $120.23 | Professional | 55 · Aftercare only | $112.20 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $79.43 Typical High $79.43 | Professional | 56 · Pre-op care only | $75.86 | $79.43 | $79.43 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $562.34 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $524.81 | $562.34 | $562.34 |
Where Virginia sits
The same service costs 3.1 times more in Oklahoma 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
OK $6,701MD $2,187
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.