How much rates vary
Facilitymedian $3,631 · 10th to 90th $525 to $9,550Professionalmedian $525 · 10th to 90th $427 to $759
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 $524.81 Median $5,370.32 Typical High $14,125.38 | Facility | None | $524.81 | $5,370.32 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $501.19 Median $524.81 Typical High $724.44 | Professional | None | $501.19 | $524.81 | $724.44 |
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 $457.09 Median $537.03 Typical High $645.65 | Professional | None | $457.09 | $537.03 | $645.65 |
CareFirst Setting Professional Modifier None Typical Low $478.63 Median $537.03 Typical High $691.83 | Professional | None | $478.63 | $537.03 | $691.83 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $1,698.24 Typical High $3,090.30 | Facility | None | $524.81 | $1,698.24 | $3,090.30 |
Cigna Setting Professional Modifier None Typical Low $446.68 Median $489.78 Typical High $758.58 | Professional | None | $446.68 | $489.78 | $758.58 |
Kaiser Permanente Setting Professional Modifier None Typical Low $426.58 Median $512.86 Typical High $645.65 | Professional | None | $426.58 | $512.86 | $645.65 |
Medcost Setting Professional Modifier None Typical Low $630.96 Median $794.33 Typical High $794.33 | Professional | None | $630.96 | $794.33 | $794.33 |
Medcost Setting Facility Modifier None Typical Low $524.81 Median $616.60 Typical High $851.14 | Facility | None | $524.81 | $616.60 | $851.14 |
Medcost Setting Professional Modifier None Typical Low $512.86 Median $575.44 Typical High $630.96 | Professional | None | $512.86 | $575.44 | $630.96 |
Sentara Setting Facility Modifier None Typical Low $446.68 Median $1,737.80 Typical High $8,709.64 | Facility | None | $446.68 | $1,737.80 | $8,709.64 |
Sentara Setting Professional Modifier None Typical Low $467.74 Median $562.34 Typical High $1,148.15 | Professional | None | $467.74 | $562.34 | $1,148.15 |
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 $331.13 Median $436.52 Typical High $851.14 | Professional | None | $331.13 | $436.52 | $851.14 |
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 $251.19 Median $263.03 Typical High $263.03 | Professional | 52 · Reduced service | $251.19 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $104.71 Typical High $104.71 | Professional | 53 · Discontinued | $100.00 | $104.71 | $104.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $398.11 Typical High $398.11 | Professional | 54 · Surgery only | $380.19 | $398.11 | $398.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $79.43 Typical High $79.43 | Professional | 55 · Aftercare only | $75.86 | $79.43 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $52.48 Typical High $52.48 | Professional | 56 · Pre-op care only | $50.12 | $52.48 | $52.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $354.81 Median $371.54 Typical High $371.54 | Professional | 78 · Unplanned return to OR | $354.81 | $371.54 | $371.54 |
Where Virginia sits
The same service costs 4.6 times more in Alabama than in Montana. 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
AL $7,006MT $1,517
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.