How much rates vary
Facilitymedian $933 · 10th to 90th $191 to $4,365Professionalmedian $398 · 10th to 90th $309 to $550
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 $389.05 Median $4,073.80 Typical High $10,000.00 | Facility | None | $389.05 | $4,073.80 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $724.44 | Professional | None | $380.19 | $380.19 | $724.44 |
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 $346.74 Median $416.87 Typical High $489.78 | Professional | None | $346.74 | $416.87 | $489.78 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $512.86 Median $616.60 Typical High $741.31 | Professional | 50 · Both sides | $512.86 | $616.60 | $741.31 |
CareFirst Setting Professional Modifier None Typical Low $380.19 Median $416.87 Typical High $489.78 | Professional | None | $380.19 | $416.87 | $489.78 |
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 $316.23 Median $380.19 Typical High $549.54 | Professional | None | $316.23 | $380.19 | $549.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $354.81 Median $426.58 Typical High $549.54 | Professional | None | $354.81 | $426.58 | $549.54 |
Medcost Setting Professional Modifier None Typical Low $371.54 Median $467.74 Typical High $467.74 | Professional | None | $371.54 | $467.74 | $467.74 |
Medcost Setting Facility Modifier None Typical Low $380.19 Median $389.05 Typical High $616.60 | Facility | None | $380.19 | $389.05 | $616.60 |
Medcost Setting Professional Modifier None Typical Low $257.04 Median $288.40 Typical High $380.19 | Professional | None | $257.04 | $288.40 | $380.19 |
Sentara Setting Facility Modifier None Typical Low $275.42 Median $602.56 Typical High $2,691.53 | Facility | None | $275.42 | $602.56 | $2,691.53 |
Sentara Setting Professional Modifier None Typical Low $257.04 Median $389.05 Typical High $831.76 | Professional | None | $257.04 | $389.05 | $831.76 |
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 $229.09 Median $309.03 Typical High $616.60 | Professional | None | $229.09 | $309.03 | $616.60 |
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 $190.55 Median $190.55 Typical High $194.98 | Professional | 52 · Reduced service | $190.55 | $190.55 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $75.86 Typical High $77.62 | Professional | 53 · Discontinued | $75.86 | $75.86 | $77.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $281.84 Median $281.84 Typical High $288.40 | Professional | 54 · Surgery only | $281.84 | $281.84 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $56.23 Typical High $57.54 | Professional | 55 · Aftercare only | $56.23 | $56.23 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $38.02 Typical High $38.90 | Professional | 56 · Pre-op care only | $38.02 | $38.02 | $38.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $263.03 Median $263.03 Typical High $269.15 | Professional | 78 · Unplanned return to OR | $263.03 | $263.03 | $269.15 |
Where Virginia sits
The same service costs 5.9 times more in Colorado than in Kentucky. 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 $4,303KY $729
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.