How much rates vary
Facilitymedian $3,802 · 10th to 90th $661 to $10,965Professionalmedian $562 · 10th to 90th $457 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 $676.08 Median $4,786.30 Typical High $10,964.78 | Facility | None | $676.08 | $4,786.30 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $524.81 Median $549.54 Typical High $1,096.48 | Professional | None | $524.81 | $549.54 | $1,096.48 |
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 $467.74 Median $562.34 Typical High $676.08 | Professional | None | $467.74 | $562.34 | $676.08 |
CareFirst Setting Professional Modifier None Typical Low $501.19 Median $562.34 Typical High $741.31 | Professional | None | $501.19 | $562.34 | $741.31 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $1,698.24 Typical High $3,235.94 | Facility | None | $645.65 | $1,698.24 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $478.63 Median $512.86 Typical High $891.25 | Professional | None | $478.63 | $512.86 | $891.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $457.09 Median $549.54 Typical High $691.83 | Professional | None | $457.09 | $549.54 | $691.83 |
Medcost Setting Professional Modifier None Typical Low $912.01 Median $1,148.15 Typical High $1,148.15 | Professional | None | $912.01 | $1,148.15 | $1,148.15 |
Medcost Setting Facility Modifier None Typical Low $549.54 Median $707.95 Typical High $891.25 | Facility | None | $549.54 | $707.95 | $891.25 |
Medcost Setting Professional Modifier None Typical Low $549.54 Median $645.65 Typical High $676.08 | Professional | None | $549.54 | $645.65 | $676.08 |
Sentara Setting Facility Modifier None Typical Low $512.86 Median $1,819.70 Typical High $10,232.93 | Facility | None | $512.86 | $1,819.70 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $501.19 Median $676.08 Typical High $1,174.90 | Professional | None | $501.19 | $676.08 | $1,174.90 |
United Setting Facility Modifier None Typical Low $1,548.82 Median $6,760.83 Typical High $16,595.87 | Facility | None | $1,548.82 | $6,760.83 | $16,595.87 |
United Setting Professional Modifier None Typical Low $346.74 Median $489.78 Typical High $1,047.13 | Professional | None | $346.74 | $489.78 | $1,047.13 |
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 $275.42 Typical High $275.42 | Professional | 52 · Reduced service | $263.03 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $109.65 Typical High $109.65 | Professional | 53 · Discontinued | $104.71 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $416.87 Typical High $416.87 | Professional | 54 · Surgery only | $398.11 | $416.87 | $416.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $83.18 Typical High $83.18 | Professional | 55 · Aftercare only | $79.43 | $83.18 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $54.95 Typical High $54.95 | Professional | 56 · Pre-op care only | $52.48 | $54.95 | $54.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $389.05 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $371.54 | $389.05 | $389.05 |
Where Virginia sits
The same service costs 4.5 times more in Wisconsin 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
WI $7,285MT $1,607
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.