How much rates vary
Facilitymedian $4,266 · 10th to 90th $851 to $10,965Professionalmedian $871 · 10th to 90th $692 to $1,230
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 $870.96 Median $5,370.32 Typical High $14,125.38 | Facility | None | $870.96 | $5,370.32 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $1,230.27 | Professional | None | $831.76 | $831.76 | $1,230.27 |
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 $758.58 Median $912.01 Typical High $1,096.48 | Professional | None | $758.58 | $912.01 | $1,096.48 |
CareFirst Setting Professional Modifier None Typical Low $812.83 Median $891.25 Typical High $1,174.90 | Professional | None | $812.83 | $891.25 | $1,174.90 |
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 $724.44 Median $812.83 Typical High $1,258.93 | Professional | None | $724.44 | $812.83 | $1,258.93 |
Kaiser Permanente Setting Professional Modifier None Typical Low $758.58 Median $912.01 Typical High $1,174.90 | Professional | None | $758.58 | $912.01 | $1,174.90 |
Medcost Setting Professional Modifier None Typical Low $1,071.52 Median $1,318.26 Typical High $1,318.26 | Professional | None | $1,071.52 | $1,318.26 | $1,318.26 |
Medcost Setting Facility Modifier None Typical Low $831.76 Median $954.99 Typical High $1,348.96 | Facility | None | $831.76 | $954.99 | $1,348.96 |
Medcost Setting Professional Modifier None Typical Low $776.25 Median $891.25 Typical High $1,584.89 | Professional | None | $776.25 | $891.25 | $1,584.89 |
Sentara Setting Facility Modifier None Typical Low $776.25 Median $2,089.30 Typical High $10,232.93 | Facility | None | $776.25 | $2,089.30 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $758.58 Median $933.25 Typical High $1,905.46 | Professional | None | $758.58 | $933.25 | $1,905.46 |
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 $537.03 Median $741.31 Typical High $1,412.54 | Professional | None | $537.03 | $741.31 | $1,412.54 |
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 $416.87 Median $416.87 Typical High $436.52 | Professional | 52 · Reduced service | $416.87 | $416.87 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $165.96 Typical High $173.78 | Professional | 53 · Discontinued | $165.96 | $165.96 | $173.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $630.96 Typical High $645.65 | Professional | 54 · Surgery only | $630.96 | $630.96 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $125.89 Typical High $128.82 | Professional | 55 · Aftercare only | $125.89 | $125.89 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $83.18 Typical High $87.10 | Professional | 56 · Pre-op care only | $83.18 | $83.18 | $87.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $588.84 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $588.84 | $588.84 | $602.56 |
Where Virginia sits
The same service costs 3.1 times more in Wisconsin than in Hawaii. 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
WI $7,619HI $2,493
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.