How much rates vary
Facilitymedian $3,090 · 10th to 90th $490 to $9,550Professionalmedian $427 · 10th to 90th $339 to $759
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 $407.38 Median $5,248.07 Typical High $10,000.00 | Facility | None | $407.38 | $5,248.07 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $371.54 Median $575.44 Typical High $794.33 | Professional | None | $371.54 | $575.44 | $794.33 |
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 $338.84 Median $407.38 Typical High $489.78 | Professional | None | $338.84 | $407.38 | $489.78 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $512.86 Median $602.56 Typical High $741.31 | Professional | 50 · Both sides | $512.86 | $602.56 | $741.31 |
CareFirst Setting Professional Modifier None Typical Low $363.08 Median $398.11 Typical High $524.81 | Professional | None | $363.08 | $398.11 | $524.81 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $1,698.24 Typical High $3,090.30 | Facility | None | $524.81 | $1,698.24 | $3,090.30 |
Cigna Setting Professional Modifier None Typical Low $354.81 Median $524.81 Typical High $776.25 | Professional | None | $354.81 | $524.81 | $776.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $549.54 Median $660.69 Typical High $831.76 | Professional | None | $549.54 | $660.69 | $831.76 |
Medcost Setting Professional Modifier None Typical Low $630.96 Median $794.33 Typical High $812.83 | Professional | None | $630.96 | $794.33 | $812.83 |
Medcost Setting Facility Modifier None Typical Low $407.38 Median $630.96 Typical High $1,023.29 | Facility | None | $407.38 | $630.96 | $1,023.29 |
Medcost Setting Professional Modifier None Typical Low $416.87 Median $588.84 Typical High $645.65 | Professional | None | $416.87 | $588.84 | $645.65 |
Sentara Setting Facility Modifier None Typical Low $354.81 Median $1,445.44 Typical High $8,709.64 | Facility | None | $354.81 | $1,445.44 | $8,709.64 |
Sentara Setting Professional Modifier None Typical Low $524.81 Median $660.69 Typical High $1,318.26 | Professional | None | $524.81 | $660.69 | $1,318.26 |
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 $275.42 Median $467.74 Typical High $870.96 | Professional | None | $275.42 | $467.74 | $870.96 |
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 $186.21 Median $257.04 Typical High $309.03 | Professional | 52 · Reduced service | $186.21 | $257.04 | $309.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $102.33 Typical High $125.89 | Professional | 53 · Discontinued | $74.13 | $102.33 | $125.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $281.84 Median $389.05 Typical High $467.74 | Professional | 54 · Surgery only | $281.84 | $389.05 | $467.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $77.62 Typical High $93.33 | Professional | 55 · Aftercare only | $56.23 | $77.62 | $93.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $51.29 Typical High $63.10 | Professional | 56 · Pre-op care only | $37.15 | $51.29 | $63.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $263.03 Median $363.08 Typical High $436.52 | Professional | 78 · Unplanned return to OR | $263.03 | $363.08 | $436.52 |
Where Virginia sits
The same service costs 4.7 times more in Colorado 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
CO $6,438MT $1,383
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.