How much rates vary
Facilitymedian $2,570 · 10th to 90th $269 to $9,550Professionalmedian $224 · 10th to 90th $174 to $490
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 $354.81 Median $3,981.07 Typical High $9,332.54 | Facility | None | $354.81 | $3,981.07 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $186.21 Median $354.81 Typical High $478.63 | Professional | None | $186.21 | $354.81 | $478.63 |
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 $173.78 Median $204.17 Typical High $251.19 | Professional | None | $173.78 | $204.17 | $251.19 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $257.04 Median $309.03 Typical High $371.54 | Professional | 50 · Both sides | $257.04 | $309.03 | $371.54 |
CareFirst Setting Professional Modifier None Typical Low $181.97 Median $199.53 Typical High $263.03 | Professional | None | $181.97 | $199.53 | $263.03 |
Cigna Setting Facility Modifier None Typical Low $346.74 Median $891.25 Typical High $1,698.24 | Facility | None | $346.74 | $891.25 | $1,698.24 |
Cigna Setting Professional Modifier None Typical Low $181.97 Median $316.23 Typical High $501.19 | Professional | None | $181.97 | $316.23 | $501.19 |
Kaiser Permanente Setting Professional Modifier None Typical Low $331.13 Median $398.11 Typical High $501.19 | Professional | None | $331.13 | $398.11 | $501.19 |
Medcost Setting Professional Modifier None Typical Low $512.86 Median $645.65 Typical High $676.08 | Professional | None | $512.86 | $645.65 | $676.08 |
Medcost Setting Facility Modifier None Typical Low $208.93 Median $346.74 Typical High $630.96 | Facility | None | $208.93 | $346.74 | $630.96 |
Medcost Setting Professional Modifier None Typical Low $229.09 Median $288.40 Typical High $426.58 | Professional | None | $229.09 | $288.40 | $426.58 |
Sentara Setting Facility Modifier None Typical Low $194.98 Median $933.25 Typical High $8,709.64 | Facility | None | $194.98 | $933.25 | $8,709.64 |
Sentara Setting Professional Modifier None Typical Low $323.59 Median $457.09 Typical High $831.76 | Professional | None | $323.59 | $457.09 | $831.76 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $4,897.79 Typical High $13,182.57 | Facility | None | $1,230.27 | $4,897.79 | $13,182.57 |
United Setting Professional Modifier None Typical Low $144.54 Median $281.84 Typical High $575.44 | Professional | None | $144.54 | $281.84 | $575.44 |
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 $93.33 Median $144.54 Typical High $194.98 | Professional | 52 · Reduced service | $93.33 | $144.54 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $58.88 Typical High $77.62 | Professional | 53 · Discontinued | $38.02 | $58.88 | $77.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $218.78 Typical High $288.40 | Professional | 54 · Surgery only | $141.25 | $218.78 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $43.65 Typical High $57.54 | Professional | 55 · Aftercare only | $28.18 | $43.65 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $28.84 Typical High $38.90 | Professional | 56 · Pre-op care only | $18.62 | $28.84 | $38.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $131.83 Median $204.17 Typical High $269.15 | Professional | 78 · Unplanned return to OR | $131.83 | $204.17 | $269.15 |
Where Virginia sits
The same service costs 6.4 times more in Oklahoma than in North Dakota. 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
OK $5,125ND $804
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.