How much rates vary
Facilitymedian $661 · 10th to 90th $145 to $4,365Professionalmedian $275 · 10th to 90th $219 to $427
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 $288.40 Median $4,073.80 Typical High $10,000.00 | Facility | None | $288.40 | $4,073.80 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $275.42 Median $316.23 Typical High $323.59 | Professional | None | $275.42 | $316.23 | $323.59 |
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 $218.78 Median $263.03 Typical High $316.23 | Professional | None | $218.78 | $263.03 | $316.23 |
CareFirst Setting Professional Modifier None Typical Low $245.47 Median $269.15 Typical High $323.59 | Professional | None | $245.47 | $269.15 | $323.59 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $154.88 Typical High $288.40 | Facility | None | $50.12 | $154.88 | $288.40 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $269.15 Typical High $446.68 | Professional | None | $229.09 | $269.15 | $446.68 |
Kaiser Permanente Setting Professional Modifier None Typical Low $257.04 Median $309.03 Typical High $380.19 | Professional | None | $257.04 | $309.03 | $380.19 |
Medcost Setting Professional Modifier None Typical Low $346.74 Median $436.52 Typical High $436.52 | Professional | None | $346.74 | $436.52 | $436.52 |
Medcost Setting Facility Modifier None Typical Low $288.40 Median $338.84 Typical High $524.81 | Facility | None | $288.40 | $338.84 | $524.81 |
Medcost Setting Professional Modifier None Typical Low $251.19 Median $346.74 Typical High $446.68 | Professional | None | $251.19 | $346.74 | $446.68 |
Sentara Setting Facility Modifier None Typical Low $251.19 Median $478.63 Typical High $2,691.53 | Facility | None | $251.19 | $478.63 | $2,691.53 |
Sentara Setting Professional Modifier None Typical Low $263.03 Median $331.13 Typical High $691.83 | Professional | None | $263.03 | $331.13 | $691.83 |
United Setting Facility Modifier None Typical Low $100.00 Median $660.69 Typical High $2,089.30 | Facility | None | $100.00 | $660.69 | $2,089.30 |
United Setting Professional Modifier None Typical Low $186.21 Median $257.04 Typical High $512.86 | Professional | None | $186.21 | $257.04 | $512.86 |
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 $138.04 Median $144.54 Typical High $162.18 | Professional | 52 · Reduced service | $138.04 | $144.54 | $162.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $58.88 Typical High $64.57 | Professional | 53 · Discontinued | $54.95 | $58.88 | $64.57 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $218.78 Typical High $245.47 | Professional | 54 · Surgery only | $208.93 | $218.78 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $43.65 Typical High $48.98 | Professional | 55 · Aftercare only | $41.69 | $43.65 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $29.51 Typical High $32.36 | Professional | 56 · Pre-op care only | $27.54 | $29.51 | $32.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $194.98 Median $204.17 Typical High $229.09 | Professional | 78 · Unplanned return to OR | $194.98 | $204.17 | $229.09 |
Where Virginia sits
The same service costs 10.5 times more in Colorado than in Florida. 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 $4,157FL $396
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.