How much rates vary
Facilitymedian $1,862 · 10th to 90th $550 to $5,888Professionalmedian $589 · 10th to 90th $468 to $813
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 $741.31 Median $3,801.89 Typical High $9,332.54 | Facility | None | $741.31 | $3,801.89 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $562.34 Median $588.84 Typical High $954.99 | Professional | None | $562.34 | $588.84 | $954.99 |
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 $501.19 Median $602.56 Typical High $724.44 | Professional | None | $501.19 | $602.56 | $724.44 |
CareFirst Setting Professional Modifier None Typical Low $537.03 Median $588.84 Typical High $707.95 | Professional | None | $537.03 | $588.84 | $707.95 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $870.96 Typical High $2,187.76 | Facility | None | $478.63 | $870.96 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $489.78 Median $549.54 Typical High $831.76 | Professional | None | $489.78 | $549.54 | $831.76 |
Kaiser Permanente Setting Professional Modifier None Typical Low $478.63 Median $575.44 Typical High $724.44 | Professional | None | $478.63 | $575.44 | $724.44 |
Medcost Setting Professional Modifier None Typical Low $616.60 Median $776.25 Typical High $776.25 | Professional | None | $616.60 | $776.25 | $776.25 |
Medcost Setting Facility Modifier None Typical Low $588.84 Median $616.60 Typical High $954.99 | Facility | None | $588.84 | $616.60 | $954.99 |
Medcost Setting Professional Modifier None Typical Low $549.54 Median $549.54 Typical High $630.96 | Professional | None | $549.54 | $549.54 | $630.96 |
Sentara Setting Facility Modifier None Typical Low $446.68 Median $1,071.52 Typical High $3,630.78 | Facility | None | $446.68 | $1,071.52 | $3,630.78 |
Sentara Setting Professional Modifier None Typical Low $407.38 Median $588.84 Typical High $1,288.25 | Professional | None | $407.38 | $588.84 | $1,288.25 |
United Setting Facility Modifier None Typical Low $588.84 Median $2,187.76 Typical High $5,888.44 | Facility | None | $588.84 | $2,187.76 | $5,888.44 |
United Setting Professional Modifier None Typical Low $354.81 Median $467.74 Typical High $954.99 | Professional | None | $354.81 | $467.74 | $954.99 |
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 $275.42 Median $295.12 Typical High $295.12 | Professional | 52 · Reduced service | $275.42 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $117.49 Typical High $117.49 | Professional | 53 · Discontinued | $112.20 | $117.49 | $117.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $446.68 Typical High $446.68 | Professional | 54 · Surgery only | $416.87 | $446.68 | $446.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $89.13 Typical High $89.13 | Professional | 55 · Aftercare only | $83.18 | $89.13 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $58.88 Typical High $58.88 | Professional | 56 · Pre-op care only | $56.23 | $58.88 | $58.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $416.87 Typical High $416.87 | Professional | 78 · Unplanned return to OR | $389.05 | $416.87 | $416.87 |
Where Virginia sits
The same service costs 4.0 times more in Colorado than in Maryland. 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 $5,106MD $1,261
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.