How much rates vary
Facilitymedian $851 · 10th to 90th $224 to $4,074Professionalmedian $479 · 10th to 90th $372 to $692
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 $501.19 Median $2,041.74 Typical High $8,317.64 | Facility | None | $501.19 | $2,041.74 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $457.09 Median $501.19 Typical High $512.86 | Professional | None | $457.09 | $501.19 | $512.86 |
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 $407.38 Median $489.78 Typical High $588.84 | Professional | None | $407.38 | $489.78 | $588.84 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $616.60 Median $741.31 Typical High $891.25 | Professional | 50 · Both sides | $616.60 | $741.31 | $891.25 |
CareFirst Setting Professional Modifier None Typical Low $446.68 Median $489.78 Typical High $645.65 | Professional | None | $446.68 | $489.78 | $645.65 |
Cigna Setting Facility Modifier None Typical Low $346.74 Median $891.25 Typical High $1,698.24 | Facility | None | $346.74 | $891.25 | $1,698.24 |
Cigna Setting Professional Modifier None Typical Low $407.38 Median $478.63 Typical High $724.44 | Professional | None | $407.38 | $478.63 | $724.44 |
Kaiser Permanente Setting Professional Modifier None Typical Low $501.19 Median $602.56 Typical High $776.25 | Professional | None | $501.19 | $602.56 | $776.25 |
Medcost Setting Professional Modifier None Typical Low $549.54 Median $676.08 Typical High $676.08 | Professional | None | $549.54 | $676.08 | $676.08 |
Medcost Setting Facility Modifier None Typical Low $467.74 Median $512.86 Typical High $831.76 | Facility | None | $467.74 | $512.86 | $831.76 |
Medcost Setting Professional Modifier None Typical Low $275.42 Median $489.78 Typical High $512.86 | Professional | None | $275.42 | $489.78 | $512.86 |
Sentara Setting Facility Modifier None Typical Low $323.59 Median $707.95 Typical High $2,570.40 | Facility | None | $323.59 | $707.95 | $2,570.40 |
Sentara Setting Professional Modifier None Typical Low $426.58 Median $512.86 Typical High $1,096.48 | Professional | None | $426.58 | $512.86 | $1,096.48 |
United Setting Facility Modifier None Typical Low $100.00 Median $660.69 Typical High $2,089.30 | Facility | None | $100.00 | $660.69 | $2,089.30 |
United Setting Professional Modifier None Typical Low $302.00 Median $416.87 Typical High $812.83 | Professional | None | $302.00 | $416.87 | $812.83 |
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 $229.09 Median $234.42 Typical High $257.04 | Professional | 52 · Reduced service | $229.09 | $234.42 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $95.50 Typical High $102.33 | Professional | 53 · Discontinued | $91.20 | $95.50 | $102.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $346.74 Median $354.81 Typical High $380.19 | Professional | 54 · Surgery only | $346.74 | $354.81 | $380.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $70.79 Typical High $77.62 | Professional | 55 · Aftercare only | $69.18 | $70.79 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $46.77 Typical High $51.29 | Professional | 56 · Pre-op care only | $45.71 | $46.77 | $51.29 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $323.59 Median $331.13 Typical High $354.81 | Professional | 78 · Unplanned return to OR | $323.59 | $331.13 | $354.81 |
Where Virginia sits
The same service costs 5.3 times more in Colorado 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
CO $4,377FL $831
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.