How much rates vary
Facilitymedian $1,698 · 10th to 90th $562 to $5,754Professionalmedian $562 · 10th to 90th $447 to $832
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 $616.60 Median $2,137.96 Typical High $8,317.64 | Facility | None | $616.60 | $2,137.96 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $524.81 Median $588.84 Typical High $831.76 | Professional | None | $524.81 | $588.84 | $831.76 |
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 $467.74 Median $562.34 Typical High $676.08 | Professional | None | $467.74 | $562.34 | $676.08 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $707.95 Median $851.14 Typical High $1,023.29 | Professional | 50 · Both sides | $707.95 | $851.14 | $1,023.29 |
CareFirst Setting Professional Modifier None Typical Low $501.19 Median $562.34 Typical High $707.95 | Professional | None | $501.19 | $562.34 | $707.95 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $1,000.00 Typical High $2,187.76 | Facility | None | $478.63 | $1,000.00 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $478.63 Median $562.34 Typical High $831.76 | Professional | None | $478.63 | $562.34 | $831.76 |
Kaiser Permanente Setting Professional Modifier None Typical Low $588.84 Median $707.95 Typical High $891.25 | Professional | None | $588.84 | $707.95 | $891.25 |
Medcost Setting Professional Modifier None Typical Low $691.83 Median $870.96 Typical High $870.96 | Professional | None | $691.83 | $870.96 | $870.96 |
Medcost Setting Facility Modifier None Typical Low $562.34 Median $645.65 Typical High $1,000.00 | Facility | None | $562.34 | $645.65 | $1,000.00 |
Medcost Setting Professional Modifier None Typical Low $660.69 Median $741.31 Typical High $758.58 | Professional | None | $660.69 | $741.31 | $758.58 |
Sentara Setting Facility Modifier None Typical Low $446.68 Median $1,071.52 Typical High $3,630.78 | Facility | None | $446.68 | $1,071.52 | $3,630.78 |
Sentara Setting Professional Modifier None Typical Low $549.54 Median $660.69 Typical High $1,318.26 | Professional | None | $549.54 | $660.69 | $1,318.26 |
United Setting Facility Modifier None Typical Low $588.84 Median $2,187.76 Typical High $5,888.44 | Facility | None | $588.84 | $2,187.76 | $5,888.44 |
United Setting Professional Modifier None Typical Low $363.08 Median $489.78 Typical High $954.99 | Professional | None | $363.08 | $489.78 | $954.99 |
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 $263.03 Median $275.42 Typical High $309.03 | Professional | 52 · Reduced service | $263.03 | $275.42 | $309.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $112.20 Typical High $123.03 | Professional | 53 · Discontinued | $104.71 | $112.20 | $123.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $416.87 Typical High $457.09 | Professional | 54 · Surgery only | $389.05 | $416.87 | $457.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $83.18 Typical High $91.20 | Professional | 55 · Aftercare only | $77.62 | $83.18 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $56.23 Typical High $61.66 | Professional | 56 · Pre-op care only | $52.48 | $56.23 | $61.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $389.05 Typical High $426.58 | Professional | 78 · Unplanned return to OR | $363.08 | $389.05 | $426.58 |
Where Virginia sits
The same service costs 4.0 times more in Colorado than in Alabama. 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 $5,057AL $1,277
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.