How much rates vary
Facilitymedian $3,162 · 10th to 90th $646 to $9,550Professionalmedian $646 · 10th to 90th $525 to $933
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 $812.83 Median $4,786.30 Typical High $9,332.54 | Facility | None | $812.83 | $4,786.30 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $588.84 Median $645.65 Typical High $1,096.48 | Professional | None | $588.84 | $645.65 | $1,096.48 |
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 $537.03 Median $645.65 Typical High $776.25 | Professional | None | $537.03 | $645.65 | $776.25 |
CareFirst Setting Professional Modifier None Typical Low $562.34 Median $630.96 Typical High $812.83 | Professional | None | $562.34 | $630.96 | $812.83 |
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 $549.54 Median $588.84 Typical High $933.25 | Professional | None | $549.54 | $588.84 | $933.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $524.81 Median $630.96 Typical High $776.25 | Professional | None | $524.81 | $630.96 | $776.25 |
Medcost Setting Professional Modifier None Typical Low $812.83 Median $1,023.29 Typical High $1,023.29 | Professional | None | $812.83 | $1,023.29 | $1,023.29 |
Medcost Setting Facility Modifier None Typical Low $645.65 Median $831.76 Typical High $1,071.52 | Facility | None | $645.65 | $831.76 | $1,071.52 |
Medcost Setting Professional Modifier None Typical Low $630.96 Median $691.83 Typical High $758.58 | Professional | None | $630.96 | $691.83 | $758.58 |
Sentara Setting Facility Modifier None Typical Low $575.44 Median $1,737.80 Typical High $8,709.64 | Facility | None | $575.44 | $1,737.80 | $8,709.64 |
Sentara Setting Professional Modifier None Typical Low $575.44 Median $724.44 Typical High $1,380.38 | Professional | None | $575.44 | $724.44 | $1,380.38 |
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 $407.38 Median $575.44 Typical High $1,047.13 | Professional | None | $407.38 | $575.44 | $1,047.13 |
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 $295.12 Median $323.59 Typical High $323.59 | Professional | 52 · Reduced service | $295.12 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $117.49 Median $131.83 Typical High $131.83 | Professional | 53 · Discontinued | $117.49 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $489.78 Typical High $489.78 | Professional | 54 · Surgery only | $436.52 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $97.72 Typical High $97.72 | Professional | 55 · Aftercare only | $87.10 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $64.57 Typical High $64.57 | Professional | 56 · Pre-op care only | $58.88 | $64.57 | $64.57 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $407.38 Median $457.09 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $407.38 | $457.09 | $457.09 |
Where Virginia sits
The same service costs 4.5 times more in Alabama 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
AL $8,278MT $1,845
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.