How much rates vary
Facilitymedian $2,138 · 10th to 90th $575 to $6,918Professionalmedian $603 · 10th to 90th $501 to $871
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 $602.56 Median $4,786.30 Typical High $10,000.00 | Facility | None | $602.56 | $4,786.30 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $575.44 Median $602.56 Typical High $977.24 | Professional | None | $575.44 | $602.56 | $977.24 |
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 $512.86 Median $616.60 Typical High $741.31 | Professional | None | $512.86 | $616.60 | $741.31 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $776.25 Median $933.25 Typical High $1,122.02 | Professional | 50 · Both sides | $776.25 | $933.25 | $1,122.02 |
CareFirst Setting Professional Modifier None Typical Low $537.03 Median $602.56 Typical High $776.25 | Professional | None | $537.03 | $602.56 | $776.25 |
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 $512.86 Median $562.34 Typical High $851.14 | Professional | None | $512.86 | $562.34 | $851.14 |
Kaiser Permanente Setting Professional Modifier None Typical Low $501.19 Median $602.56 Typical High $758.58 | Professional | None | $501.19 | $602.56 | $758.58 |
Medcost Setting Professional Modifier None Typical Low $724.44 Median $912.01 Typical High $912.01 | Professional | None | $724.44 | $912.01 | $912.01 |
Medcost Setting Facility Modifier None Typical Low $602.56 Median $724.44 Typical High $1,000.00 | Facility | None | $602.56 | $724.44 | $1,000.00 |
Medcost Setting Professional Modifier None Typical Low $549.54 Median $630.96 Typical High $660.69 | Professional | None | $549.54 | $630.96 | $660.69 |
Sentara Setting Facility Modifier None Typical Low $512.86 Median $1,071.52 Typical High $3,630.78 | Facility | None | $512.86 | $1,071.52 | $3,630.78 |
Sentara Setting Professional Modifier None Typical Low $537.03 Median $660.69 Typical High $1,288.25 | Professional | None | $537.03 | $660.69 | $1,288.25 |
United Setting Facility Modifier None Typical Low $588.84 Median $2,187.76 Typical High $5,888.44 | Facility | None | $588.84 | $2,187.76 | $5,888.44 |
United Setting Professional Modifier None Typical Low $380.19 Median $512.86 Typical High $977.24 | Professional | None | $380.19 | $512.86 | $977.24 |
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 $288.40 Median $302.00 Typical High $302.00 | Professional | 52 · Reduced service | $288.40 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $123.03 Typical High $123.03 | Professional | 53 · Discontinued | $114.82 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $457.09 Typical High $457.09 | Professional | 54 · Surgery only | $426.58 | $457.09 | $457.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $91.20 Typical High $91.20 | Professional | 55 · Aftercare only | $85.11 | $91.20 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $60.26 Typical High $60.26 | Professional | 56 · Pre-op care only | $57.54 | $60.26 | $60.26 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $426.58 Typical High $426.58 | Professional | 78 · Unplanned return to OR | $398.11 | $426.58 | $426.58 |
Where Virginia sits
The same service costs 4.6 times more in Colorado than in Delaware. 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 $6,382DE $1,376
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.