How much rates vary
Facilitymedian $8,913 · 10th to 90th $427 to $46,774Professionalmedian $398 · 10th to 90th $316 to $692
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 $5,623.41 Typical High $14,125.38 | Facility | None | $426.58 | $5,623.41 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $380.19 Median $426.58 Typical High $3,981.07 | Professional | None | $380.19 | $426.58 | $3,981.07 |
Anthem BCBS Setting Facility Modifier None Typical Low $40,738.03 Median $47,863.01 Typical High $53,703.18 | Facility | None | $40,738.03 | $47,863.01 | $53,703.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $316.23 Median $371.54 Typical High $467.74 | Professional | None | $316.23 | $371.54 | $467.74 |
CareFirst Setting Professional Modifier None Typical Low $316.23 Median $354.81 Typical High $4,677.35 | Professional | None | $316.23 | $354.81 | $4,677.35 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $6,456.54 Typical High $12,589.25 | Facility | None | $512.86 | $6,456.54 | $12,589.25 |
Cigna Setting Professional Modifier None Typical Low $323.59 Median $426.58 Typical High $616.60 | Professional | None | $323.59 | $426.58 | $616.60 |
Kaiser Permanente Setting Professional Modifier None Typical Low $288.40 Median $346.74 Typical High $426.58 | Professional | None | $288.40 | $346.74 | $426.58 |
Medcost Setting Facility Modifier None Typical Low $380.19 Median $467.74 Typical High $630.96 | Facility | None | $380.19 | $467.74 | $630.96 |
Medcost Setting Professional Modifier None Typical Low $446.68 Median $446.68 Typical High $446.68 | Professional | None | $446.68 | $446.68 | $446.68 |
Sentara Setting Facility Modifier None Typical Low $331.13 Median $1,548.82 Typical High $18,620.87 | Facility | None | $331.13 | $1,548.82 | $18,620.87 |
Sentara Setting Professional Modifier None Typical Low $331.13 Median $457.09 Typical High $11,481.54 | Professional | None | $331.13 | $457.09 | $11,481.54 |
United Setting Facility Modifier None Typical Low $4,570.88 Median $14,454.40 Typical High $56,234.13 | Facility | None | $4,570.88 | $14,454.40 | $56,234.13 |
United Setting Professional Modifier None Typical Low $309.03 Median $501.19 Typical High $758.58 | Professional | None | $309.03 | $501.19 | $758.58 |
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 $190.55 Median $190.55 Typical High $213.80 | Professional | 52 · Reduced service | $190.55 | $190.55 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $75.86 Typical High $85.11 | Professional | 53 · Discontinued | $75.86 | $75.86 | $85.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $288.40 Median $288.40 Typical High $323.59 | Professional | 54 · Surgery only | $288.40 | $288.40 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $57.54 Typical High $64.57 | Professional | 55 · Aftercare only | $57.54 | $57.54 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $38.02 Typical High $42.66 | Professional | 56 · Pre-op care only | $38.02 | $38.02 | $42.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $269.15 Median $269.15 Typical High $302.00 | Professional | 78 · Unplanned return to OR | $269.15 | $269.15 | $302.00 |
Where Virginia sits
The same service costs 21.5 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 $21,837MT $1,015
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.