How much rates vary
Facilitymedian $4,365 · 10th to 90th $646 to $14,791Professionalmedian $631 · 10th to 90th $513 to $933
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 $645.65 Median $4,365.16 Typical High $10,964.78 | Facility | None | $645.65 | $4,365.16 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $616.60 Median $645.65 Typical High $1,047.13 | Professional | None | $616.60 | $645.65 | $1,047.13 |
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 $549.54 Median $660.69 Typical High $776.25 | Professional | None | $549.54 | $660.69 | $776.25 |
CareFirst Setting Professional Modifier None Typical Low $588.84 Median $660.69 Typical High $851.14 | Professional | None | $588.84 | $660.69 | $851.14 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $1,698.24 Typical High $3,235.94 | Facility | None | $645.65 | $1,698.24 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $524.81 Median $602.56 Typical High $891.25 | Professional | None | $524.81 | $602.56 | $891.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $524.81 Median $630.96 Typical High $794.33 | Professional | None | $524.81 | $630.96 | $794.33 |
Medcost Setting Professional Modifier None Typical Low $575.44 Median $724.44 Typical High $724.44 | Professional | None | $575.44 | $724.44 | $724.44 |
Medcost Setting Facility Modifier None Typical Low $645.65 Median $707.95 Typical High $1,047.13 | Facility | None | $645.65 | $707.95 | $1,047.13 |
Medcost Setting Professional Modifier None Typical Low $588.84 Median $630.96 Typical High $676.08 | Professional | None | $588.84 | $630.96 | $676.08 |
Sentara Setting Facility Modifier None Typical Low $489.78 Median $2,137.96 Typical High $10,715.19 | Facility | None | $489.78 | $2,137.96 | $10,715.19 |
Sentara Setting Professional Modifier None Typical Low $501.19 Median $645.65 Typical High $1,380.38 | Professional | None | $501.19 | $645.65 | $1,380.38 |
United Setting Facility Modifier None Typical Low $2,570.40 Median $10,000.00 Typical High $25,118.86 | Facility | None | $2,570.40 | $10,000.00 | $25,118.86 |
United Setting Professional Modifier None Typical Low $380.19 Median $512.86 Typical High $1,047.13 | Professional | None | $380.19 | $512.86 | $1,047.13 |
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 $309.03 Median $323.59 Typical High $323.59 | Professional | 52 · Reduced service | $309.03 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $128.82 Typical High $128.82 | Professional | 53 · Discontinued | $123.03 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $489.78 Typical High $489.78 | Professional | 54 · Surgery only | $457.09 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $97.72 Typical High $97.72 | Professional | 55 · Aftercare only | $91.20 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $64.57 Typical High $64.57 | Professional | 56 · Pre-op care only | $61.66 | $64.57 | $64.57 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $457.09 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $426.58 | $457.09 | $457.09 |
Where Virginia sits
The same service costs 4.7 times more in Oklahoma 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
OK $8,820MT $1,888
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.