How much rates vary
Facilitymedian $437 · 10th to 90th $145 to $2,692Professionalmedian $302 · 10th to 90th $229 to $437
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 $288.40 Median $398.11 Typical High $8,317.64 | Facility | None | $288.40 | $398.11 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $281.84 Median $309.03 Typical High $446.68 | Professional | None | $281.84 | $309.03 | $446.68 |
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 $257.04 Median $309.03 Typical High $371.54 | Professional | None | $257.04 | $309.03 | $371.54 |
CareFirst Setting Professional Modifier None Typical Low $275.42 Median $309.03 Typical High $363.08 | Professional | None | $275.42 | $309.03 | $363.08 |
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 $245.47 Median $295.12 Typical High $457.09 | Professional | None | $245.47 | $295.12 | $457.09 |
Kaiser Permanente Setting Professional Modifier None Typical Low $354.81 Median $416.87 Typical High $537.03 | Professional | None | $354.81 | $416.87 | $537.03 |
Medcost Setting Professional Modifier None Typical Low $331.13 Median $407.38 Typical High $436.52 | Professional | None | $331.13 | $407.38 | $436.52 |
Medcost Setting Facility Modifier None Typical Low $288.40 Median $309.03 Typical High $512.86 | Facility | None | $288.40 | $309.03 | $512.86 |
Medcost Setting Professional Modifier None Typical Low $87.10 Median $104.71 Typical High $316.23 | Professional | None | $87.10 | $104.71 | $316.23 |
Sentara Setting Facility Modifier None Typical Low $229.09 Median $436.52 Typical High $2,454.71 | Facility | None | $229.09 | $436.52 | $2,454.71 |
Sentara Setting Professional Modifier None Typical Low $257.04 Median $323.59 Typical High $676.08 | Professional | None | $257.04 | $323.59 | $676.08 |
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 $186.21 Median $251.19 Typical High $489.78 | Professional | None | $186.21 | $251.19 | $489.78 |
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 $141.25 Median $147.91 Typical High $158.49 | Professional | 52 · Reduced service | $141.25 | $147.91 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $58.88 Typical High $63.10 | Professional | 53 · Discontinued | $56.23 | $58.88 | $63.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $213.80 Median $223.87 Typical High $234.42 | Professional | 54 · Surgery only | $213.80 | $223.87 | $234.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $44.67 Typical High $46.77 | Professional | 55 · Aftercare only | $42.66 | $44.67 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $29.51 Typical High $31.62 | Professional | 56 · Pre-op care only | $28.18 | $29.51 | $31.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $199.53 Median $208.93 Typical High $218.78 | Professional | 78 · Unplanned return to OR | $199.53 | $208.93 | $218.78 |
Where Virginia sits
The same service costs 6.4 times more in Colorado 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
CO $2,602FL $408
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.