How much rates vary
Facilitymedian $4,571 · 10th to 90th $759 to $11,220Professionalmedian $741 · 10th to 90th $589 to $1,318
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 $891.25 Median $5,370.32 Typical High $14,125.38 | Facility | None | $891.25 | $5,370.32 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $724.44 Median $812.83 Typical High $3,981.07 | Professional | None | $724.44 | $812.83 | $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 $588.84 Median $707.95 Typical High $891.25 | Professional | None | $588.84 | $707.95 | $891.25 |
CareFirst Setting Professional Modifier None Typical Low $602.56 Median $660.69 Typical High $5,128.61 | Professional | None | $602.56 | $660.69 | $5,128.61 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $2,187.76 Typical High $4,570.88 | Facility | None | $512.86 | $2,187.76 | $4,570.88 |
Cigna Setting Professional Modifier None Typical Low $602.56 Median $776.25 Typical High $1,096.48 | Professional | None | $602.56 | $776.25 | $1,096.48 |
Kaiser Permanente Setting Professional Modifier None Typical Low $537.03 Median $645.65 Typical High $794.33 | Professional | None | $537.03 | $645.65 | $794.33 |
Medcost Setting Professional Modifier None Typical Low $851.14 Median $1,047.13 Typical High $1,047.13 | Professional | None | $851.14 | $1,047.13 | $1,047.13 |
Medcost Setting Facility Modifier None Typical Low $724.44 Median $912.01 Typical High $1,174.90 | Facility | None | $724.44 | $912.01 | $1,174.90 |
Medcost Setting Professional Modifier None Typical Low $870.96 Median $870.96 Typical High $870.96 | Professional | None | $870.96 | $870.96 | $870.96 |
Sentara Setting Facility Modifier None Typical Low $616.60 Median $1,819.70 Typical High $10,232.93 | Facility | None | $616.60 | $1,819.70 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $616.60 Median $851.14 Typical High $8,511.38 | Professional | None | $616.60 | $851.14 | $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 $575.44 Median $912.01 Typical High $1,380.38 | Professional | None | $575.44 | $912.01 | $1,380.38 |
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 $363.08 Typical High $398.11 | Professional | 52 · Reduced service | $363.08 | $363.08 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $144.54 Typical High $162.18 | Professional | 53 · Discontinued | $144.54 | $144.54 | $162.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $537.03 Typical High $602.56 | Professional | 54 · Surgery only | $537.03 | $537.03 | $602.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $107.15 Typical High $120.23 | Professional | 55 · Aftercare only | $107.15 | $107.15 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $72.44 Typical High $81.28 | Professional | 56 · Pre-op care only | $72.44 | $72.44 | $81.28 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $501.19 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $501.19 | $501.19 | $562.34 |
Where Virginia sits
The same service costs 4.7 times more in Wisconsin than in Kentucky. 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 $8,213KY $1,765
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.