How much rates vary
Facilitymedian $741 · 10th to 90th $174 to $3,802Professionalmedian $537 · 10th to 90th $427 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 $549.54 Median $2,041.74 Typical High $8,317.64 | Facility | None | $549.54 | $2,041.74 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $501.19 Median $549.54 Typical High $812.83 | Professional | None | $501.19 | $549.54 | $812.83 |
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 $457.09 Median $537.03 Typical High $645.65 | Professional | None | $457.09 | $537.03 | $645.65 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $676.08 Median $812.83 Typical High $977.24 | Professional | 50 · Both sides | $676.08 | $812.83 | $977.24 |
CareFirst Setting Professional Modifier None Typical Low $478.63 Median $537.03 Typical High $630.96 | Professional | None | $478.63 | $537.03 | $630.96 |
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 $446.68 Median $524.81 Typical High $794.33 | Professional | None | $446.68 | $524.81 | $794.33 |
Kaiser Permanente Setting Professional Modifier None Typical Low $602.56 Median $724.44 Typical High $912.01 | Professional | None | $602.56 | $724.44 | $912.01 |
Medcost Setting Professional Modifier None Typical Low $616.60 Median $776.25 Typical High $776.25 | Professional | None | $616.60 | $776.25 | $776.25 |
Medcost Setting Facility Modifier None Typical Low $537.03 Median $588.84 Typical High $954.99 | Facility | None | $537.03 | $588.84 | $954.99 |
Medcost Setting Professional Modifier None Typical Low $309.03 Median $371.54 Typical High $588.84 | Professional | None | $309.03 | $371.54 | $588.84 |
Sentara Setting Facility Modifier None Typical Low $371.54 Median $630.96 Typical High $2,454.71 | Facility | None | $371.54 | $630.96 | $2,454.71 |
Sentara Setting Professional Modifier None Typical Low $501.19 Median $602.56 Typical High $1,230.27 | Professional | None | $501.19 | $602.56 | $1,230.27 |
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 $933.25 | Professional | None | $346.74 | $467.74 | $933.25 |
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 $251.19 Median $269.15 Typical High $288.40 | Professional | 52 · Reduced service | $251.19 | $269.15 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $107.15 Typical High $117.49 | Professional | 53 · Discontinued | $100.00 | $107.15 | $117.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $407.38 Typical High $436.52 | Professional | 54 · Surgery only | $380.19 | $407.38 | $436.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $81.28 Typical High $87.10 | Professional | 55 · Aftercare only | $75.86 | $81.28 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $53.70 Typical High $58.88 | Professional | 56 · Pre-op care only | $50.12 | $53.70 | $58.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $354.81 Median $380.19 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $354.81 | $380.19 | $407.38 |
Where Virginia sits
The same service costs 5.2 times more in Connecticut 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
CT $3,468DE $666
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.