How much rates vary
Facilitymedian $4,266 · 10th to 90th $708 to $10,965Professionalmedian $617 · 10th to 90th $513 to $955
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 $616.60 Median $5,370.32 Typical High $14,125.38 | Facility | None | $616.60 | $5,370.32 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $588.84 Median $616.60 Typical High $870.96 | Professional | None | $588.84 | $616.60 | $870.96 |
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 $537.03 Median $645.65 Typical High $776.25 | Professional | None | $537.03 | $645.65 | $776.25 |
CareFirst Setting Professional Modifier None Typical Low $575.44 Median $630.96 Typical High $831.76 | Professional | None | $575.44 | $630.96 | $831.76 |
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 $537.03 Median $575.44 Typical High $1,000.00 | Professional | None | $537.03 | $575.44 | $1,000.00 |
Kaiser Permanente Setting Professional Modifier None Typical Low $512.86 Median $616.60 Typical High $776.25 | Professional | None | $512.86 | $616.60 | $776.25 |
Medcost Setting Professional Modifier None Typical Low $1,000.00 Median $1,258.93 Typical High $1,258.93 | Professional | None | $1,000.00 | $1,258.93 | $1,258.93 |
Medcost Setting Facility Modifier None Typical Low $616.60 Median $794.33 Typical High $1,023.29 | Facility | None | $616.60 | $794.33 | $1,023.29 |
Medcost Setting Professional Modifier None Typical Low $602.56 Median $724.44 Typical High $794.33 | Professional | None | $602.56 | $724.44 | $794.33 |
Sentara Setting Facility Modifier None Typical Low $575.44 Median $1,819.70 Typical High $10,232.93 | Facility | None | $575.44 | $1,819.70 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $562.34 Median $758.58 Typical High $1,348.96 | Professional | None | $562.34 | $758.58 | $1,348.96 |
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 $389.05 Median $549.54 Typical High $1,174.90 | Professional | None | $389.05 | $549.54 | $1,174.90 |
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 $295.12 Median $309.03 Typical High $309.03 | Professional | 52 · Reduced service | $295.12 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $125.89 Typical High $125.89 | Professional | 53 · Discontinued | $120.23 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $467.74 Typical High $467.74 | Professional | 54 · Surgery only | $446.68 | $467.74 | $467.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $93.33 Typical High $93.33 | Professional | 55 · Aftercare only | $89.13 | $93.33 | $93.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $61.66 Typical High $61.66 | Professional | 56 · Pre-op care only | $58.88 | $61.66 | $61.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $436.52 Typical High $436.52 | Professional | 78 · Unplanned return to OR | $416.87 | $436.52 | $436.52 |
Where Virginia sits
The same service costs 4.1 times more in Oklahoma 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
OK $7,594MT $1,845
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.