How much rates vary
Facilitymedian $3,388 · 10th to 90th $468 to $10,000Professionalmedian $427 · 10th to 90th $339 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 $501.19 Median $5,370.32 Typical High $10,964.78 | Facility | None | $501.19 | $5,370.32 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $426.58 Typical High $3,981.07 | Professional | None | $407.38 | $426.58 | $3,981.07 |
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 $338.84 Median $398.11 Typical High $512.86 | Professional | None | $338.84 | $398.11 | $512.86 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $501.19 Median $602.56 Typical High $776.25 | Professional | 50 · Both sides | $501.19 | $602.56 | $776.25 |
CareFirst Setting Professional Modifier None Typical Low $346.74 Median $389.05 Typical High $3,890.45 | Professional | None | $346.74 | $389.05 | $3,890.45 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $1,778.28 Typical High $3,311.31 | Facility | None | $645.65 | $1,778.28 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $346.74 Median $426.58 Typical High $630.96 | Professional | None | $346.74 | $426.58 | $630.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $295.12 Median $346.74 Typical High $436.52 | Professional | None | $295.12 | $346.74 | $436.52 |
Medcost Setting Professional Modifier None Typical Low $512.86 Median $630.96 Typical High $630.96 | Professional | None | $512.86 | $630.96 | $630.96 |
Medcost Setting Facility Modifier None Typical Low $407.38 Median $501.19 Typical High $660.69 | Facility | None | $407.38 | $501.19 | $660.69 |
Medcost Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $467.74 | Professional | None | $467.74 | $467.74 | $467.74 |
Sentara Setting Facility Modifier None Typical Low $371.54 Median $1,445.44 Typical High $8,709.64 | Facility | None | $371.54 | $1,445.44 | $8,709.64 |
Sentara Setting Professional Modifier None Typical Low $363.08 Median $478.63 Typical High $4,570.88 | Professional | None | $363.08 | $478.63 | $4,570.88 |
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 $295.12 Median $478.63 Typical High $724.44 | Professional | None | $295.12 | $478.63 | $724.44 |
3 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 54 · Surgery only Typical Low $295.12 Median $302.00 Typical High $316.23 | Professional | 54 · Surgery only | $295.12 | $302.00 | $316.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $61.66 Typical High $63.10 | Professional | 55 · Aftercare only | $58.88 | $61.66 | $63.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $40.74 Typical High $42.66 | Professional | 56 · Pre-op care only | $38.90 | $40.74 | $42.66 |
Where Virginia sits
The same service costs 6.7 times more in Oklahoma 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
OK $7,024MT $1,050
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.