How much rates vary
Facilitymedian $2,951 · 10th to 90th $501 to $9,550Professionalmedian $537 · 10th to 90th $389 to $759
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 $602.56 Median $4,073.80 Typical High $9,332.54 | Facility | None | $602.56 | $4,073.80 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $457.09 Median $575.44 Typical High $812.83 | Professional | None | $457.09 | $575.44 | $812.83 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,884.03 Median $3,715.35 Typical High $4,265.80 | Facility | None | $2,884.03 | $3,715.35 | $4,265.80 |
Anthem BCBS Setting Professional Modifier None Typical Low $389.05 Median $524.81 Typical High $724.44 | Professional | None | $389.05 | $524.81 | $724.44 |
CareFirst Setting Professional Modifier None Typical Low $389.05 Median $426.58 Typical High $501.19 | Professional | None | $389.05 | $426.58 | $501.19 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $1,513.56 Typical High $2,818.38 | Facility | None | $478.63 | $1,513.56 | $2,818.38 |
Cigna Setting Professional Modifier None Typical Low $407.38 Median $549.54 Typical High $741.31 | Professional | None | $407.38 | $549.54 | $741.31 |
Kaiser Permanente Setting Professional Modifier None Typical Low $512.86 Median $676.08 Typical High $794.33 | Professional | None | $512.86 | $676.08 | $794.33 |
Medcost Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $831.76 | Professional | None | $660.69 | $660.69 | $831.76 |
Medcost Setting Facility Modifier None Typical Low $457.09 Median $602.56 Typical High $1,000.00 | Facility | None | $457.09 | $602.56 | $1,000.00 |
Medcost Setting Professional Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $1,071.52 | Professional | None | $1,071.52 | $1,071.52 | $1,071.52 |
Sentara Setting Facility Modifier None Typical Low $380.19 Median $1,479.11 Typical High $8,709.64 | Facility | None | $380.19 | $1,479.11 | $8,709.64 |
Sentara Setting Professional Modifier None Typical Low $512.86 Median $676.08 Typical High $5,128.61 | Professional | None | $512.86 | $676.08 | $5,128.61 |
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 $354.81 Median $524.81 Typical High $891.25 | Professional | None | $354.81 | $524.81 | $891.25 |
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 $223.87 Median $257.04 Typical High $338.84 | Professional | 52 · Reduced service | $223.87 | $257.04 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $102.33 Typical High $134.90 | Professional | 53 · Discontinued | $91.20 | $102.33 | $134.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $389.05 Typical High $512.86 | Professional | 54 · Surgery only | $338.84 | $389.05 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $77.62 Typical High $102.33 | Professional | 55 · Aftercare only | $67.61 | $77.62 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $51.29 Typical High $67.61 | Professional | 56 · Pre-op care only | $45.71 | $51.29 | $67.61 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $316.23 Median $363.08 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $316.23 | $363.08 | $478.63 |
Where Virginia sits
The same service costs 4.6 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 $6,614MT $1,440
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.