How much rates vary
Facilitymedian $759 · 10th to 90th $162 to $3,981Professionalmedian $501 · 10th to 90th $398 to $741
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 $524.81 Median $3,981.07 Typical High $9,332.54 | Facility | None | $524.81 | $3,981.07 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $489.78 Median $524.81 Typical High $645.65 | Professional | None | $489.78 | $524.81 | $645.65 |
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 $436.52 Median $524.81 Typical High $630.96 | Professional | None | $436.52 | $524.81 | $630.96 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $645.65 Median $776.25 Typical High $933.25 | Professional | 50 · Both sides | $645.65 | $776.25 | $933.25 |
CareFirst Setting Professional Modifier None Typical Low $467.74 Median $512.86 Typical High $616.60 | Professional | None | $467.74 | $512.86 | $616.60 |
Cigna Setting Facility Modifier None Typical Low $138.04 Median $323.59 Typical High $1,621.81 | Facility | None | $138.04 | $323.59 | $1,621.81 |
Cigna Setting Professional Modifier None Typical Low $426.58 Median $501.19 Typical High $741.31 | Professional | None | $426.58 | $501.19 | $741.31 |
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 $588.84 Median $741.31 Typical High $741.31 | Professional | None | $588.84 | $741.31 | $741.31 |
Medcost Setting Facility Modifier None Typical Low $501.19 Median $549.54 Typical High $870.96 | Facility | None | $501.19 | $549.54 | $870.96 |
Medcost Setting Professional Modifier None Typical Low $489.78 Median $549.54 Typical High $707.95 | Professional | None | $489.78 | $549.54 | $707.95 |
Sentara Setting Facility Modifier None Typical Low $371.54 Median $588.84 Typical High $2,454.71 | Facility | None | $371.54 | $588.84 | $2,454.71 |
Sentara Setting Professional Modifier None Typical Low $478.63 Median $562.34 Typical High $1,148.15 | Professional | None | $478.63 | $562.34 | $1,148.15 |
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 $316.23 Median $426.58 Typical High $851.14 | Professional | None | $316.23 | $426.58 | $851.14 |
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 $239.88 Median $251.19 Typical High $269.15 | Professional | 52 · Reduced service | $239.88 | $251.19 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $100.00 Typical High $107.15 | Professional | 53 · Discontinued | $97.72 | $100.00 | $107.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $371.54 Typical High $398.11 | Professional | 54 · Surgery only | $363.08 | $371.54 | $398.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $74.13 Typical High $79.43 | Professional | 55 · Aftercare only | $72.44 | $74.13 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $50.12 Typical High $53.70 | Professional | 56 · Pre-op care only | $48.98 | $50.12 | $53.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $346.74 Typical High $371.54 | Professional | 78 · Unplanned return to OR | $338.84 | $346.74 | $371.54 |
Where Virginia sits
The same service costs 4.9 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 $3,107FL $640
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.