How much rates vary
Facilitymedian $1,995 · 10th to 90th $407 to $9,120Professionalmedian $372 · 10th to 90th $295 to $646
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 $426.58 Median $691.83 Typical High $8,317.64 | Facility | None | $426.58 | $691.83 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $316.23 Median $489.78 Typical High $691.83 | Professional | None | $316.23 | $489.78 | $691.83 |
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 $295.12 Median $346.74 Typical High $426.58 | Professional | None | $295.12 | $346.74 | $426.58 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $436.52 Median $524.81 Typical High $630.96 | Professional | 50 · Both sides | $436.52 | $524.81 | $630.96 |
CareFirst Setting Professional Modifier None Typical Low $309.03 Median $346.74 Typical High $446.68 | Professional | None | $309.03 | $346.74 | $446.68 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $1,023.29 Typical High $2,570.40 | Facility | None | $524.81 | $1,023.29 | $2,570.40 |
Cigna Setting Professional Modifier None Typical Low $309.03 Median $446.68 Typical High $660.69 | Professional | None | $309.03 | $446.68 | $660.69 |
Kaiser Permanente Setting Professional Modifier None Typical Low $457.09 Median $549.54 Typical High $691.83 | Professional | None | $457.09 | $549.54 | $691.83 |
Medcost Setting Professional Modifier None Typical Low $501.19 Median $630.96 Typical High $630.96 | Professional | None | $501.19 | $630.96 | $630.96 |
Medcost Setting Facility Modifier None Typical Low $346.74 Median $537.03 Typical High $870.96 | Facility | None | $346.74 | $537.03 | $870.96 |
Medcost Setting Professional Modifier None Typical Low $389.05 Median $407.38 Typical High $549.54 | Professional | None | $389.05 | $407.38 | $549.54 |
Sentara Setting Facility Modifier None Typical Low $302.00 Median $1,148.15 Typical High $8,709.64 | Facility | None | $302.00 | $1,148.15 | $8,709.64 |
Sentara Setting Professional Modifier None Typical Low $380.19 Median $524.81 Typical High $1,122.02 | Professional | None | $380.19 | $524.81 | $1,122.02 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $4,897.79 Typical High $13,182.57 | Facility | None | $1,230.27 | $4,897.79 | $13,182.57 |
United Setting Professional Modifier None Typical Low $234.42 Median $398.11 Typical High $741.31 | Professional | None | $234.42 | $398.11 | $741.31 |
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 $158.49 Median $218.78 Typical High $269.15 | Professional | 52 · Reduced service | $158.49 | $218.78 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $87.10 Typical High $107.15 | Professional | 53 · Discontinued | $63.10 | $87.10 | $107.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $331.13 Typical High $398.11 | Professional | 54 · Surgery only | $239.88 | $331.13 | $398.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $66.07 Typical High $79.43 | Professional | 55 · Aftercare only | $47.86 | $66.07 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $43.65 Typical High $53.70 | Professional | 56 · Pre-op care only | $31.62 | $43.65 | $53.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $223.87 Median $309.03 Typical High $371.54 | Professional | 78 · Unplanned return to OR | $223.87 | $309.03 | $371.54 |
Where Virginia sits
The same service costs 5.2 times more in Colorado than in West Virginia. 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 $4,833WV $936
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.