How much rates vary
Facilitymedian $4,467 · 10th to 90th $525 to $11,220Professionalmedian $501 · 10th to 90th $407 to $708
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 $1,230.27 Median $5,623.41 Typical High $15,488.17 | Facility | None | $1,230.27 | $5,623.41 | $15,488.17 |
Aetna Setting Professional Modifier None Typical Low $478.63 Median $501.19 Typical High $691.83 | Professional | None | $478.63 | $501.19 | $691.83 |
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 $426.58 Median $512.86 Typical High $616.60 | Professional | None | $426.58 | $512.86 | $616.60 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $645.65 Median $776.25 Typical High $933.25 | Professional | 50 · Both sides | $645.65 | $776.25 | $933.25 |
CareFirst Setting Professional Modifier None Typical Low $467.74 Median $512.86 Typical High $676.08 | Professional | None | $467.74 | $512.86 | $676.08 |
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 $426.58 Median $467.74 Typical High $707.95 | Professional | None | $426.58 | $467.74 | $707.95 |
Kaiser Permanente Setting Professional Modifier None Typical Low $426.58 Median $512.86 Typical High $645.65 | Professional | None | $426.58 | $512.86 | $645.65 |
Medcost Setting Professional Modifier None Typical Low $588.84 Median $741.31 Typical High $741.31 | Professional | None | $588.84 | $741.31 | $741.31 |
Medcost Setting Facility Modifier None Typical Low $501.19 Median $575.44 Typical High $831.76 | Facility | None | $501.19 | $575.44 | $831.76 |
Medcost Setting Professional Modifier None Typical Low $524.81 Median $537.03 Typical High $630.96 | Professional | None | $524.81 | $537.03 | $630.96 |
Sentara Setting Facility Modifier None Typical Low $416.87 Median $1,737.80 Typical High $10,232.93 | Facility | None | $416.87 | $1,737.80 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $446.68 Median $537.03 Typical High $1,096.48 | Professional | None | $446.68 | $537.03 | $1,096.48 |
United Setting Facility Modifier None Typical Low $1,548.82 Median $6,760.83 Typical High $16,595.87 | Facility | None | $1,548.82 | $6,760.83 | $16,595.87 |
United Setting Professional Modifier None Typical Low $316.23 Median $407.38 Typical High $812.83 | Professional | None | $316.23 | $407.38 | $812.83 |
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 $239.88 Median $251.19 Typical High $251.19 | Professional | 52 · Reduced service | $239.88 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $102.33 Typical High $102.33 | Professional | 53 · Discontinued | $95.50 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $380.19 Typical High $380.19 | Professional | 54 · Surgery only | $363.08 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $75.86 Typical High $75.86 | Professional | 55 · Aftercare only | $72.44 | $75.86 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $50.12 Typical High $50.12 | Professional | 56 · Pre-op care only | $47.86 | $50.12 | $50.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $354.81 Typical High $354.81 | Professional | 78 · Unplanned return to OR | $338.84 | $354.81 | $354.81 |
Where Virginia sits
The same service costs 4.9 times more in Wisconsin 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
WI $7,341MT $1,483
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.