How much rates vary
Facilitymedian $3,890 · 10th to 90th $776 to $11,220Professionalmedian $776 · 10th to 90th $631 to $1,122
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 $776.25 Median $4,786.30 Typical High $14,125.38 | Facility | None | $776.25 | $4,786.30 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $724.44 Median $776.25 Typical High $1,258.93 | Professional | None | $724.44 | $776.25 | $1,258.93 |
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 $645.65 Median $776.25 Typical High $933.25 | Professional | None | $645.65 | $776.25 | $933.25 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $977.24 Median $1,174.90 Typical High $1,412.54 | Professional | 50 · Both sides | $977.24 | $1,174.90 | $1,412.54 |
CareFirst Setting Professional Modifier None Typical Low $691.83 Median $776.25 Typical High $1,000.00 | Professional | None | $691.83 | $776.25 | $1,000.00 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $1,819.70 Typical High $3,090.30 | Facility | None | $524.81 | $1,819.70 | $3,090.30 |
Cigna Setting Professional Modifier None Typical Low $660.69 Median $707.95 Typical High $1,096.48 | Professional | None | $660.69 | $707.95 | $1,096.48 |
Kaiser Permanente Setting Professional Modifier None Typical Low $616.60 Median $741.31 Typical High $933.25 | Professional | None | $616.60 | $741.31 | $933.25 |
Medcost Setting Professional Modifier None Typical Low $891.25 Median $1,122.02 Typical High $1,122.02 | Professional | None | $891.25 | $1,122.02 | $1,122.02 |
Medcost Setting Facility Modifier None Typical Low $776.25 Median $912.01 Typical High $1,288.25 | Facility | None | $776.25 | $912.01 | $1,288.25 |
Medcost Setting Professional Modifier None Typical Low $851.14 Median $870.96 Typical High $912.01 | Professional | None | $851.14 | $870.96 | $912.01 |
Sentara Setting Facility Modifier None Typical Low $616.60 Median $1,862.09 Typical High $10,232.93 | Facility | None | $616.60 | $1,862.09 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $691.83 Median $812.83 Typical High $1,659.59 | Professional | None | $691.83 | $812.83 | $1,659.59 |
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 $478.63 Median $630.96 Typical High $1,258.93 | Professional | None | $478.63 | $630.96 | $1,258.93 |
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 $363.08 Median $389.05 Typical High $389.05 | Professional | 52 · Reduced service | $363.08 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $158.49 Typical High $158.49 | Professional | 53 · Discontinued | $144.54 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $588.84 Typical High $588.84 | Professional | 54 · Surgery only | $537.03 | $588.84 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $117.49 Typical High $117.49 | Professional | 55 · Aftercare only | $109.65 | $117.49 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $77.62 Typical High $77.62 | Professional | 56 · Pre-op care only | $72.44 | $77.62 | $77.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $549.54 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $501.19 | $549.54 | $549.54 |
Where Virginia sits
The same service costs 3.6 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 $7,904MT $2,218
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.