How much rates vary
Facilitymedian $501 · 10th to 90th $145 to $2,951Professionalmedian $324 · 10th to 90th $245 to $479
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 $346.74 Median $512.86 Typical High $9,332.54 | Facility | None | $346.74 | $512.86 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $295.12 Median $346.74 Typical High $457.09 | Professional | None | $295.12 | $346.74 | $457.09 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,698.24 Median $2,398.83 Typical High $2,951.21 | Facility | None | $1,698.24 | $2,398.83 | $2,951.21 |
Anthem BCBS Setting Professional Modifier None Typical Low $269.15 Median $323.59 Typical High $380.19 | Professional | None | $269.15 | $323.59 | $380.19 |
CareFirst Setting Professional Modifier None Typical Low $288.40 Median $323.59 Typical High $380.19 | Professional | None | $288.40 | $323.59 | $380.19 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $141.25 Typical High $263.03 | Facility | None | $50.12 | $141.25 | $263.03 |
Cigna Setting Professional Modifier None Typical Low $281.84 Median $331.13 Typical High $501.19 | Professional | None | $281.84 | $331.13 | $501.19 |
Kaiser Permanente Setting Professional Modifier None Typical Low $371.54 Median $446.68 Typical High $562.34 | Professional | None | $371.54 | $446.68 | $562.34 |
Medcost Setting Professional Modifier None Typical Low $389.05 Median $489.78 Typical High $489.78 | Professional | None | $389.05 | $489.78 | $489.78 |
Medcost Setting Facility Modifier None Typical Low $302.00 Median $354.81 Typical High $575.44 | Facility | None | $302.00 | $354.81 | $575.44 |
Medcost Setting Professional Modifier None Typical Low $158.49 Median $190.55 Typical High $363.08 | Professional | None | $158.49 | $190.55 | $363.08 |
Sentara Setting Facility Modifier None Typical Low $245.47 Median $467.74 Typical High $2,454.71 | Facility | None | $245.47 | $467.74 | $2,454.71 |
Sentara Setting Professional Modifier None Typical Low $295.12 Median $371.54 Typical High $776.25 | Professional | None | $295.12 | $371.54 | $776.25 |
United Setting Facility Modifier None Typical Low $100.00 Median $660.69 Typical High $2,041.74 | Facility | None | $100.00 | $660.69 | $2,041.74 |
United Setting Professional Modifier None Typical Low $199.53 Median $288.40 Typical High $549.54 | Professional | None | $199.53 | $288.40 | $549.54 |
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 $147.91 Median $162.18 Typical High $177.83 | Professional | 52 · Reduced service | $147.91 | $162.18 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $64.57 Typical High $70.79 | Professional | 53 · Discontinued | $60.26 | $64.57 | $70.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $223.87 Median $245.47 Typical High $263.03 | Professional | 54 · Surgery only | $223.87 | $245.47 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $48.98 Typical High $52.48 | Professional | 55 · Aftercare only | $44.67 | $48.98 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $32.36 Typical High $35.48 | Professional | 56 · Pre-op care only | $29.51 | $32.36 | $35.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $208.93 Median $229.09 Typical High $245.47 | Professional | 78 · Unplanned return to OR | $208.93 | $229.09 | $245.47 |
Where Virginia sits
The same service costs 6.7 times more in New York than in Florida. 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
NY $2,828FL $419
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.