How much rates vary
Facilitymedian $4,571 · 10th to 90th $617 to $11,220Professionalmedian $562 · 10th to 90th $457 to $1,000
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 $676.08 Median $5,495.41 Typical High $14,125.38 | Facility | None | $676.08 | $5,495.41 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $549.54 Median $616.60 Typical High $4,365.16 | Professional | None | $549.54 | $616.60 | $4,365.16 |
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 $446.68 Median $537.03 Typical High $676.08 | Professional | None | $446.68 | $537.03 | $676.08 |
CareFirst Setting Professional Modifier None Typical Low $457.09 Median $501.19 Typical High $4,677.35 | Professional | None | $457.09 | $501.19 | $4,677.35 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $2,187.76 Typical High $4,677.35 | Facility | None | $512.86 | $2,187.76 | $4,677.35 |
Cigna Setting Professional Modifier None Typical Low $457.09 Median $602.56 Typical High $831.76 | Professional | None | $457.09 | $602.56 | $831.76 |
Kaiser Permanente Setting Professional Modifier None Typical Low $407.38 Median $489.78 Typical High $602.56 | Professional | None | $407.38 | $489.78 | $602.56 |
Medcost Setting Professional Modifier None Typical Low $660.69 Median $831.76 Typical High $831.76 | Professional | None | $660.69 | $831.76 | $831.76 |
Medcost Setting Facility Modifier None Typical Low $549.54 Median $707.95 Typical High $891.25 | Facility | None | $549.54 | $707.95 | $891.25 |
Medcost Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $660.69 | Professional | None | $660.69 | $660.69 | $660.69 |
Sentara Setting Facility Modifier None Typical Low $478.63 Median $1,819.70 Typical High $10,232.93 | Facility | None | $478.63 | $1,819.70 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $478.63 Median $676.08 Typical High $8,511.38 | Professional | None | $478.63 | $676.08 | $8,511.38 |
United Setting Facility Modifier None Typical Low $1,548.82 Median $6,760.83 Typical High $17,378.01 | Facility | None | $1,548.82 | $6,760.83 | $17,378.01 |
United Setting Professional Modifier None Typical Low $436.52 Median $691.83 Typical High $1,047.13 | Professional | None | $436.52 | $691.83 | $1,047.13 |
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 $275.42 Median $275.42 Typical High $302.00 | Professional | 52 · Reduced service | $275.42 | $275.42 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $109.65 Typical High $123.03 | Professional | 53 · Discontinued | $109.65 | $109.65 | $123.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $416.87 Typical High $457.09 | Professional | 54 · Surgery only | $416.87 | $416.87 | $457.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $83.18 Typical High $91.20 | Professional | 55 · Aftercare only | $83.18 | $83.18 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $54.95 Typical High $61.66 | Professional | 56 · Pre-op care only | $54.95 | $54.95 | $61.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $389.05 Typical High $426.58 | Professional | 78 · Unplanned return to OR | $389.05 | $389.05 | $426.58 |
Where Virginia sits
The same service costs 5.4 times more in Connecticut 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
CT $7,713MT $1,433
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.