How much rates vary
Facilitymedian $7,244 · 10th to 90th $631 to $18,197Professionalmedian $617 · 10th to 90th $479 to $8,913
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 $933.25 Median $7,585.78 Typical High $14,791.08 | Facility | None | $933.25 | $7,585.78 | $14,791.08 |
Aetna Setting Professional Modifier None Typical Low $524.81 Median $5,128.61 Typical High $7,585.78 | Professional | None | $524.81 | $5,128.61 | $7,585.78 |
Anthem BCBS Setting Facility Modifier None Typical Low $14,125.38 Median $18,620.87 Typical High $19,952.62 | Facility | None | $14,125.38 | $18,620.87 | $19,952.62 |
Anthem BCBS Setting Professional Modifier None Typical Low $478.63 Median $562.34 Typical High $691.83 | Professional | None | $478.63 | $562.34 | $691.83 |
CareFirst Setting Professional Modifier None Typical Low $489.78 Median $549.54 Typical High $724.44 | Professional | None | $489.78 | $549.54 | $724.44 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $3,715.35 Typical High $7,244.36 | Facility | None | $512.86 | $3,715.35 | $7,244.36 |
Cigna Setting Professional Modifier None Typical Low $489.78 Median $1,412.54 Typical High $9,549.93 | Professional | None | $489.78 | $1,412.54 | $9,549.93 |
Kaiser Permanente Setting Professional Modifier None Typical Low $5,754.40 Median $6,760.83 Typical High $8,912.51 | Professional | None | $5,754.40 | $6,760.83 | $8,912.51 |
Medcost Setting Professional Modifier None Typical Low $15,488.17 Median $15,488.17 Typical High $15,488.17 | Professional | None | $15,488.17 | $15,488.17 | $15,488.17 |
Medcost Setting Facility Modifier None Typical Low $588.84 Median $954.99 Typical High $12,589.25 | Facility | None | $588.84 | $954.99 | $12,589.25 |
Medcost Setting Professional Modifier None Typical Low $489.78 Median $489.78 Typical High $9,772.37 | Professional | None | $489.78 | $489.78 | $9,772.37 |
Sentara Setting Facility Modifier None Typical Low $537.03 Median $2,454.71 Typical High $12,882.50 | Facility | None | $537.03 | $2,454.71 | $12,882.50 |
Sentara Setting Professional Modifier None Typical Low $6,456.54 Median $8,912.51 Typical High $13,489.63 | Professional | None | $6,456.54 | $8,912.51 | $13,489.63 |
United Setting Facility Modifier None Typical Low $2,630.27 Median $10,000.00 Typical High $25,118.86 | Facility | None | $2,630.27 | $10,000.00 | $25,118.86 |
United Setting Professional Modifier None Typical Low $398.11 Median $4,073.80 Typical High $11,748.98 | Professional | None | $398.11 | $4,073.80 | $11,748.98 |
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 $263.03 Median $2,570.40 Typical High $3,801.89 | Professional | 52 · Reduced service | $263.03 | $2,570.40 | $3,801.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $1,023.29 Typical High $1,513.56 | Professional | 53 · Discontinued | $104.71 | $1,023.29 | $1,513.56 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $3,890.45 Typical High $5,754.40 | Professional | 54 · Surgery only | $389.05 | $3,890.45 | $5,754.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $776.25 Typical High $1,148.15 | Professional | 55 · Aftercare only | $77.62 | $776.25 | $1,148.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $512.86 Typical High $758.58 | Professional | 56 · Pre-op care only | $52.48 | $512.86 | $758.58 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $3,630.78 Typical High $5,370.32 | Professional | 78 · Unplanned return to OR | $363.08 | $3,630.78 | $5,370.32 |
Where Virginia sits
The same service costs 5.8 times more in Oklahoma than in Mississippi. 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 $20,151MS $3,493
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.