How much rates vary
Facilitymedian $3,802 · 10th to 90th $692 to $10,965Professionalmedian $692 · 10th to 90th $562 to $1,000
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 $691.83 Median $5,370.32 Typical High $14,125.38 | Facility | None | $691.83 | $5,370.32 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $1,000.00 | Professional | None | $660.69 | $660.69 | $1,000.00 |
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 $602.56 Median $724.44 Typical High $870.96 | Professional | None | $602.56 | $724.44 | $870.96 |
CareFirst Setting Professional Modifier None Typical Low $645.65 Median $724.44 Typical High $954.99 | Professional | None | $645.65 | $724.44 | $954.99 |
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 $575.44 Median $645.65 Typical High $1,023.29 | Professional | None | $575.44 | $645.65 | $1,023.29 |
Kaiser Permanente Setting Professional Modifier None Typical Low $616.60 Median $724.44 Typical High $933.25 | Professional | None | $616.60 | $724.44 | $933.25 |
Medcost Setting Professional Modifier None Typical Low $831.76 Median $1,047.13 Typical High $1,047.13 | Professional | None | $831.76 | $1,047.13 | $1,047.13 |
Medcost Setting Facility Modifier None Typical Low $660.69 Median $758.58 Typical High $1,071.52 | Facility | None | $660.69 | $758.58 | $1,071.52 |
Medcost Setting Professional Modifier None Typical Low $575.44 Median $707.95 Typical High $812.83 | Professional | None | $575.44 | $707.95 | $812.83 |
Sentara Setting Facility Modifier None Typical Low $602.56 Median $1,819.70 Typical High $10,232.93 | Facility | None | $602.56 | $1,819.70 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $602.56 Median $741.31 Typical High $1,548.82 | Professional | None | $602.56 | $741.31 | $1,548.82 |
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 $436.52 Median $588.84 Typical High $1,122.02 | Professional | None | $436.52 | $588.84 | $1,122.02 |
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 $331.13 Median $331.13 Typical High $346.74 | Professional | 52 · Reduced service | $331.13 | $331.13 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $131.83 Typical High $141.25 | Professional | 53 · Discontinued | $131.83 | $131.83 | $141.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $489.78 Typical High $524.81 | Professional | 54 · Surgery only | $489.78 | $489.78 | $524.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $97.72 Typical High $104.71 | Professional | 55 · Aftercare only | $97.72 | $97.72 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $66.07 Typical High $69.18 | Professional | 56 · Pre-op care only | $66.07 | $66.07 | $69.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $457.09 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $457.09 | $457.09 | $489.78 |
Where Virginia sits
The same service costs 3.5 times more in Wisconsin than in Montana. 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 $7,245MT $2,074
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.