How much rates vary
Facilitymedian $1,413 · 10th to 90th $427 to $4,898Professionalmedian $457 · 10th to 90th $355 to $661
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 $467.74 Median $4,073.80 Typical High $9,332.54 | Facility | None | $467.74 | $4,073.80 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $426.58 Median $467.74 Typical High $524.81 | Professional | None | $426.58 | $467.74 | $524.81 |
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 $389.05 Median $467.74 Typical High $562.34 | Professional | None | $389.05 | $467.74 | $562.34 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $588.84 Median $691.83 Typical High $831.76 | Professional | 50 · Both sides | $588.84 | $691.83 | $831.76 |
CareFirst Setting Professional Modifier None Typical Low $416.87 Median $457.09 Typical High $602.56 | Professional | None | $416.87 | $457.09 | $602.56 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $1,000.00 Typical High $2,187.76 | Facility | None | $478.63 | $1,000.00 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $457.09 Typical High $676.08 | Professional | None | $389.05 | $457.09 | $676.08 |
Kaiser Permanente Setting Professional Modifier None Typical Low $478.63 Median $575.44 Typical High $741.31 | Professional | None | $478.63 | $575.44 | $741.31 |
Medcost Setting Professional Modifier None Typical Low $524.81 Median $645.65 Typical High $660.69 | Professional | None | $524.81 | $645.65 | $660.69 |
Medcost Setting Facility Modifier None Typical Low $446.68 Median $489.78 Typical High $776.25 | Facility | None | $446.68 | $489.78 | $776.25 |
Medcost Setting Professional Modifier None Typical Low $398.11 Median $467.74 Typical High $489.78 | Professional | None | $398.11 | $467.74 | $489.78 |
Sentara Setting Facility Modifier None Typical Low $363.08 Median $758.58 Typical High $2,951.21 | Facility | None | $363.08 | $758.58 | $2,951.21 |
Sentara Setting Professional Modifier None Typical Low $436.52 Median $501.19 Typical High $1,047.13 | Professional | None | $436.52 | $501.19 | $1,047.13 |
United Setting Facility Modifier None Typical Low $323.59 Median $1,445.44 Typical High $3,630.78 | Facility | None | $323.59 | $1,445.44 | $3,630.78 |
United Setting Professional Modifier None Typical Low $288.40 Median $389.05 Typical High $758.58 | Professional | None | $288.40 | $389.05 | $758.58 |
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 $213.80 Median $223.87 Typical High $239.88 | Professional | 52 · Reduced service | $213.80 | $223.87 | $239.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $85.11 Median $89.13 Typical High $95.50 | Professional | 53 · Discontinued | $85.11 | $89.13 | $95.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $323.59 Median $331.13 Typical High $363.08 | Professional | 54 · Surgery only | $323.59 | $331.13 | $363.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $66.07 Typical High $72.44 | Professional | 55 · Aftercare only | $64.57 | $66.07 | $72.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $44.67 Typical High $47.86 | Professional | 56 · Pre-op care only | $42.66 | $44.67 | $47.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $302.00 Median $309.03 Typical High $338.84 | Professional | 78 · Unplanned return to OR | $302.00 | $309.03 | $338.84 |
Where Virginia sits
The same service costs 4.5 times more in Vermont than in Florida. 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
VT $4,521FL $1,007
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.