How much rates vary
Facilitymedian $1,445 · 10th to 90th $513 to $5,129Professionalmedian $776 · 10th to 90th $617 to $1,096
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 $794.33 Median $4,365.16 Typical High $10,000.00 | Facility | None | $794.33 | $4,365.16 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $741.31 Median $794.33 Typical High $1,096.48 | Professional | None | $741.31 | $794.33 | $1,096.48 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,884.03 Median $3,715.35 Typical High $4,265.80 | Facility | None | $2,884.03 | $3,715.35 | $4,265.80 |
Anthem BCBS Setting Professional Modifier None Typical Low $676.08 Median $794.33 Typical High $954.99 | Professional | None | $676.08 | $794.33 | $954.99 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,000.00 Median $1,202.26 Typical High $1,445.44 | Professional | 50 · Both sides | $1,000.00 | $1,202.26 | $1,445.44 |
CareFirst Setting Professional Modifier None Typical Low $707.95 Median $776.25 Typical High $933.25 | Professional | None | $707.95 | $776.25 | $933.25 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $870.96 Typical High $2,187.76 | Facility | None | $478.63 | $870.96 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $630.96 Median $724.44 Typical High $1,096.48 | Professional | None | $630.96 | $724.44 | $1,096.48 |
Kaiser Permanente Setting Professional Modifier None Typical Low $630.96 Median $758.58 Typical High $933.25 | Professional | None | $630.96 | $758.58 | $933.25 |
Medcost Setting Professional Modifier None Typical Low $912.01 Median $1,148.15 Typical High $1,148.15 | Professional | None | $912.01 | $1,148.15 | $1,148.15 |
Medcost Setting Facility Modifier None Typical Low $794.33 Median $891.25 Typical High $1,288.25 | Facility | None | $794.33 | $891.25 | $1,288.25 |
Medcost Setting Professional Modifier None Typical Low $363.08 Median $426.58 Typical High $831.76 | Professional | None | $363.08 | $426.58 | $831.76 |
Sentara Setting Facility Modifier None Typical Low $616.60 Median $1,000.00 Typical High $3,235.94 | Facility | None | $616.60 | $1,000.00 | $3,235.94 |
Sentara Setting Professional Modifier None Typical Low $676.08 Median $812.83 Typical High $1,659.59 | Professional | None | $676.08 | $812.83 | $1,659.59 |
United Setting Facility Modifier None Typical Low $323.59 Median $1,445.44 Typical High $3,630.78 | Facility | None | $323.59 | $1,445.44 | $3,630.78 |
United Setting Professional Modifier None Typical Low $489.78 Median $630.96 Typical High $1,258.93 | Professional | None | $489.78 | $630.96 | $1,258.93 |
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 $371.54 Median $389.05 Typical High $389.05 | Professional | 52 · Reduced service | $371.54 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $158.49 Typical High $158.49 | Professional | 53 · Discontinued | $147.91 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $588.84 Typical High $588.84 | Professional | 54 · Surgery only | $562.34 | $588.84 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $117.49 Typical High $117.49 | Professional | 55 · Aftercare only | $112.20 | $117.49 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $79.43 Typical High $79.43 | Professional | 56 · Pre-op care only | $74.13 | $79.43 | $79.43 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $549.54 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $524.81 | $549.54 | $549.54 |
Where Virginia sits
The same service costs 3.6 times more in Colorado than in Delaware. 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 $4,868DE $1,354
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.