How much rates vary
Facilitymedian $3,981 · 10th to 90th $468 to $12,882Professionalmedian $759 · 10th to 90th $331 to $1,445
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 $977.24 Median $5,248.07 Typical High $14,125.38 | Facility | None | $977.24 | $5,248.07 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $371.54 Median $977.24 Typical High $1,698.24 | Professional | None | $371.54 | $977.24 | $1,698.24 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,754.40 Median $8,317.64 Typical High $11,481.54 | Facility | None | $5,754.40 | $8,317.64 | $11,481.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $331.13 Median $660.69 Typical High $1,047.13 | Professional | None | $331.13 | $660.69 | $1,047.13 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $489.78 Median $1,000.00 Typical High $1,584.89 | Professional | 50 · Both sides | $489.78 | $1,000.00 | $1,584.89 |
CareFirst Setting Professional Modifier None Typical Low $323.59 Median $363.08 Typical High $4,168.69 | Professional | None | $323.59 | $363.08 | $4,168.69 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $1,659.59 Typical High $3,090.30 | Facility | None | $524.81 | $1,659.59 | $3,090.30 |
Cigna Setting Professional Modifier None Typical Low $331.13 Median $776.25 Typical High $1,479.11 | Professional | None | $331.13 | $776.25 | $1,479.11 |
Kaiser Permanente Setting Professional Modifier None Typical Low $302.00 Median $1,000.00 Typical High $1,230.27 | Professional | None | $302.00 | $1,000.00 | $1,230.27 |
Medcost Setting Professional Modifier None Typical Low $1,412.54 Median $1,778.28 Typical High $1,778.28 | Professional | None | $1,412.54 | $1,778.28 | $1,778.28 |
Medcost Setting Facility Modifier None Typical Low $371.54 Median $616.60 Typical High $1,584.89 | Facility | None | $371.54 | $616.60 | $1,584.89 |
Medcost Setting Professional Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,230.27 | Professional | None | $1,230.27 | $1,230.27 | $1,230.27 |
Sentara Setting Facility Modifier None Typical Low $338.84 Median $1,737.80 Typical High $10,232.93 | Facility | None | $338.84 | $1,737.80 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $891.25 Median $1,288.25 Typical High $10,000.00 | Professional | None | $891.25 | $1,288.25 | $10,000.00 |
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 $331.13 Median $758.58 Typical High $1,698.24 | Professional | None | $331.13 | $758.58 | $1,698.24 |
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 $186.21 Median $338.84 Typical High $549.54 | Professional | 52 · Reduced service | $186.21 | $338.84 | $549.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $138.04 Typical High $218.78 | Professional | 53 · Discontinued | $75.86 | $138.04 | $218.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $281.84 Median $512.86 Typical High $831.76 | Professional | 54 · Surgery only | $281.84 | $512.86 | $831.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $102.33 Typical High $165.96 | Professional | 55 · Aftercare only | $56.23 | $102.33 | $165.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $69.18 Typical High $109.65 | Professional | 56 · Pre-op care only | $37.15 | $69.18 | $109.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $263.03 Median $478.63 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $263.03 | $478.63 | $776.25 |
Where Virginia sits
The same service costs 4.3 times more in Colorado than in North Dakota. 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
CO $7,632ND $1,783
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.