How much rates vary
Facilitymedian $851 · 10th to 90th $162 to $4,074Professionalmedian $562 · 10th to 90th $437 to $794
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 $562.34 Median $4,073.80 Typical High $9,332.54 | Facility | None | $562.34 | $4,073.80 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $524.81 Median $562.34 Typical High $562.34 | Professional | None | $524.81 | $562.34 | $562.34 |
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 $478.63 Median $575.44 Typical High $676.08 | Professional | None | $478.63 | $575.44 | $676.08 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $707.95 Median $851.14 Typical High $1,023.29 | Professional | 50 · Both sides | $707.95 | $851.14 | $1,023.29 |
CareFirst Setting Professional Modifier None Typical Low $501.19 Median $562.34 Typical High $660.69 | Professional | None | $501.19 | $562.34 | $660.69 |
Cigna Setting Facility Modifier None Typical Low $138.04 Median $426.58 Typical High $2,187.76 | Facility | None | $138.04 | $426.58 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $467.74 Median $524.81 Typical High $794.33 | Professional | None | $467.74 | $524.81 | $794.33 |
Kaiser Permanente Setting Professional Modifier None Typical Low $537.03 Median $645.65 Typical High $812.83 | Professional | None | $537.03 | $645.65 | $812.83 |
Medcost Setting Professional Modifier None Typical Low $645.65 Median $812.83 Typical High $812.83 | Professional | None | $645.65 | $812.83 | $812.83 |
Medcost Setting Facility Modifier None Typical Low $562.34 Median $630.96 Typical High $933.25 | Facility | None | $562.34 | $630.96 | $933.25 |
Medcost Setting Professional Modifier None Typical Low $602.56 Median $676.08 Typical High $758.58 | Professional | None | $602.56 | $676.08 | $758.58 |
Sentara Setting Facility Modifier None Typical Low $371.54 Median $707.95 Typical High $2,570.40 | Facility | None | $371.54 | $707.95 | $2,570.40 |
Sentara Setting Professional Modifier None Typical Low $512.86 Median $676.08 Typical High $1,202.26 | Professional | None | $512.86 | $676.08 | $1,202.26 |
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 $346.74 Median $467.74 Typical High $912.01 | Professional | None | $346.74 | $467.74 | $912.01 |
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 $263.03 Median $281.84 Typical High $281.84 | Professional | 52 · Reduced service | $263.03 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $112.20 Typical High $112.20 | Professional | 53 · Discontinued | $104.71 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $416.87 Typical High $426.58 | Professional | 54 · Surgery only | $398.11 | $416.87 | $426.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $83.18 Typical High $85.11 | Professional | 55 · Aftercare only | $79.43 | $83.18 | $85.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $56.23 Typical High $56.23 | Professional | 56 · Pre-op care only | $52.48 | $56.23 | $56.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $389.05 Typical High $398.11 | Professional | 78 · Unplanned return to OR | $371.54 | $389.05 | $398.11 |
Where Virginia sits
The same service costs 5.2 times more in Connecticut 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
CT $3,486FL $668
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.