How much rates vary
Facilitymedian $3,388 · 10th to 90th $692 to $9,550Professionalmedian $676 · 10th to 90th $550 to $955
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 $691.83 Median $4,786.30 Typical High $10,000.00 | Facility | None | $691.83 | $4,786.30 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $616.60 Median $691.83 Typical High $933.25 | Professional | None | $616.60 | $691.83 | $933.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,677.35 Median $6,456.54 Typical High $7,244.36 | Facility | None | $4,677.35 | $6,456.54 | $7,244.36 |
Anthem BCBS Setting Professional Modifier None Typical Low $562.34 Median $676.08 Typical High $812.83 | Professional | None | $562.34 | $676.08 | $812.83 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $851.14 Median $1,023.29 Typical High $1,230.27 | Professional | 50 · Both sides | $851.14 | $1,023.29 | $1,230.27 |
CareFirst Setting Professional Modifier None Typical Low $602.56 Median $660.69 Typical High $870.96 | Professional | None | $602.56 | $660.69 | $870.96 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $1,659.59 Typical High $3,090.30 | Facility | None | $478.63 | $1,659.59 | $3,090.30 |
Cigna Setting Professional Modifier None Typical Low $575.44 Median $616.60 Typical High $977.24 | Professional | None | $575.44 | $616.60 | $977.24 |
Kaiser Permanente Setting Professional Modifier None Typical Low $549.54 Median $660.69 Typical High $812.83 | Professional | None | $549.54 | $660.69 | $812.83 |
Medcost Setting Professional Modifier None Typical Low $794.33 Median $977.24 Typical High $977.24 | Professional | None | $794.33 | $977.24 | $977.24 |
Medcost Setting Facility Modifier None Typical Low $691.83 Median $812.83 Typical High $1,122.02 | Facility | None | $691.83 | $812.83 | $1,122.02 |
Medcost Setting Professional Modifier None Typical Low $758.58 Median $812.83 Typical High $870.96 | Professional | None | $758.58 | $812.83 | $870.96 |
Sentara Setting Facility Modifier None Typical Low $549.54 Median $1,737.80 Typical High $8,709.64 | Facility | None | $549.54 | $1,737.80 | $8,709.64 |
Sentara Setting Professional Modifier None Typical Low $602.56 Median $794.33 Typical High $1,445.44 | Professional | None | $602.56 | $794.33 | $1,445.44 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $5,011.87 Typical High $13,182.57 | Facility | None | $1,230.27 | $5,011.87 | $13,182.57 |
United Setting Professional Modifier None Typical Low $426.58 Median $562.34 Typical High $1,096.48 | Professional | None | $426.58 | $562.34 | $1,096.48 |
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 $309.03 Median $346.74 Typical High $346.74 | Professional | 52 · Reduced service | $309.03 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $138.04 Typical High $138.04 | Professional | 53 · Discontinued | $125.89 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $512.86 Typical High $512.86 | Professional | 54 · Surgery only | $467.74 | $512.86 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $102.33 Typical High $102.33 | Professional | 55 · Aftercare only | $93.33 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $69.18 Typical High $69.18 | Professional | 56 · Pre-op care only | $61.66 | $69.18 | $69.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $478.63 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $436.52 | $478.63 | $478.63 |
Where Virginia sits
The same service costs 3.6 times more in Oklahoma than in Montana. 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 $6,890MT $1,932
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.