How much rates vary
Facilitymedian $661 · 10th to 90th $155 to $3,981Professionalmedian $331 · 10th to 90th $251 to $479
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 $338.84 Median $3,981.07 Typical High $9,332.54 | Facility | None | $338.84 | $3,981.07 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $309.03 Median $338.84 Typical High $524.81 | Professional | None | $309.03 | $338.84 | $524.81 |
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 $275.42 Median $331.13 Typical High $398.11 | Professional | None | $275.42 | $331.13 | $398.11 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $416.87 Median $501.19 Typical High $602.56 | Professional | 50 · Both sides | $416.87 | $501.19 | $602.56 |
CareFirst Setting Professional Modifier None Typical Low $302.00 Median $331.13 Typical High $398.11 | Professional | None | $302.00 | $331.13 | $398.11 |
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 $275.42 Median $316.23 Typical High $489.78 | Professional | None | $275.42 | $316.23 | $489.78 |
Kaiser Permanente Setting Professional Modifier None Typical Low $346.74 Median $416.87 Typical High $524.81 | Professional | None | $346.74 | $416.87 | $524.81 |
Medcost Setting Professional Modifier None Typical Low $354.81 Median $436.52 Typical High $446.68 | Professional | None | $354.81 | $436.52 | $446.68 |
Medcost Setting Facility Modifier None Typical Low $309.03 Median $338.84 Typical High $562.34 | Facility | None | $309.03 | $338.84 | $562.34 |
Medcost Setting Professional Modifier None Typical Low $199.53 Median $239.88 Typical High $346.74 | Professional | None | $199.53 | $239.88 | $346.74 |
Sentara Setting Facility Modifier None Typical Low $251.19 Median $436.52 Typical High $2,454.71 | Facility | None | $251.19 | $436.52 | $2,454.71 |
Sentara Setting Professional Modifier None Typical Low $281.84 Median $363.08 Typical High $741.31 | Professional | None | $281.84 | $363.08 | $741.31 |
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 $199.53 Median $275.42 Typical High $537.03 | Professional | None | $199.53 | $275.42 | $537.03 |
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 $154.88 Median $158.49 Typical High $169.82 | Professional | 52 · Reduced service | $154.88 | $158.49 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $63.10 Typical High $67.61 | Professional | 53 · Discontinued | $61.66 | $63.10 | $67.61 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $234.42 Median $239.88 Typical High $257.04 | Professional | 54 · Surgery only | $234.42 | $239.88 | $257.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $47.86 Typical High $51.29 | Professional | 55 · Aftercare only | $46.77 | $47.86 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $31.62 Typical High $33.88 | Professional | 56 · Pre-op care only | $30.90 | $31.62 | $33.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $218.78 Median $223.87 Typical High $239.88 | Professional | 78 · Unplanned return to OR | $218.78 | $223.87 | $239.88 |
Where Virginia sits
The same service costs 6.5 times more in Connecticut than in Maryland. 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 $3,149MD $483
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.