How much rates vary
Facilitymedian $741 · 10th to 90th $178 to $3,548Professionalmedian $525 · 10th to 90th $407 to $776
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 $549.54 Median $912.01 Typical High $8,317.64 | Facility | None | $549.54 | $912.01 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $489.78 Median $537.03 Typical High $870.96 | Professional | None | $489.78 | $537.03 | $870.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,698.24 Median $2,398.83 Typical High $2,951.21 | Facility | None | $1,698.24 | $2,398.83 | $2,951.21 |
Anthem BCBS Setting Professional Modifier None Typical Low $446.68 Median $524.81 Typical High $630.96 | Professional | None | $446.68 | $524.81 | $630.96 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $660.69 Median $794.33 Typical High $954.99 | Professional | 50 · Both sides | $660.69 | $794.33 | $954.99 |
CareFirst Setting Professional Modifier None Typical Low $467.74 Median $524.81 Typical High $616.60 | Professional | None | $467.74 | $524.81 | $616.60 |
Cigna Setting Facility Modifier None Typical Low $138.04 Median $323.59 Typical High $1,621.81 | Facility | None | $138.04 | $323.59 | $1,621.81 |
Cigna Setting Professional Modifier None Typical Low $436.52 Median $512.86 Typical High $776.25 | Professional | None | $436.52 | $512.86 | $776.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $537.03 Median $645.65 Typical High $812.83 | Professional | None | $537.03 | $645.65 | $812.83 |
Medcost Setting Professional Modifier None Typical Low $602.56 Median $758.58 Typical High $758.58 | Professional | None | $602.56 | $758.58 | $758.58 |
Medcost Setting Facility Modifier None Typical Low $512.86 Median $562.34 Typical High $891.25 | Facility | None | $512.86 | $562.34 | $891.25 |
Medcost Setting Professional Modifier None Typical Low $512.86 Median $575.44 Typical High $588.84 | Professional | None | $512.86 | $575.44 | $588.84 |
Sentara Setting Facility Modifier None Typical Low $371.54 Median $588.84 Typical High $2,454.71 | Facility | None | $371.54 | $588.84 | $2,454.71 |
Sentara Setting Professional Modifier None Typical Low $489.78 Median $562.34 Typical High $1,174.90 | Professional | None | $489.78 | $562.34 | $1,174.90 |
United Setting Facility Modifier None Typical Low $100.00 Median $660.69 Typical High $2,041.74 | Facility | None | $100.00 | $660.69 | $2,041.74 |
United Setting Professional Modifier None Typical Low $323.59 Median $446.68 Typical High $870.96 | Professional | None | $323.59 | $446.68 | $870.96 |
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 $245.47 Median $251.19 Typical High $275.42 | Professional | 52 · Reduced service | $245.47 | $251.19 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $102.33 Typical High $109.65 | Professional | 53 · Discontinued | $97.72 | $102.33 | $109.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $380.19 Typical High $407.38 | Professional | 54 · Surgery only | $371.54 | $380.19 | $407.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $75.86 Typical High $83.18 | Professional | 55 · Aftercare only | $74.13 | $75.86 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $51.29 Typical High $54.95 | Professional | 56 · Pre-op care only | $48.98 | $51.29 | $54.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $346.74 Median $354.81 Typical High $380.19 | Professional | 78 · Unplanned return to OR | $346.74 | $354.81 | $380.19 |
Where Virginia sits
The same service costs 4.7 times more in New York 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
NY $3,038FL $649
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.