How much rates vary
Facilitymedian $7,586 · 10th to 90th $562 to $16,982Professionalmedian $3,631 · 10th to 90th $417 to $7,762
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 $524.81 Median $7,585.78 Typical High $20,892.96 | Facility | None | $524.81 | $7,585.78 | $20,892.96 |
Aetna Setting Professional Modifier None Typical Low $501.19 Median $5,128.61 Typical High $7,585.78 | Professional | None | $501.19 | $5,128.61 | $7,585.78 |
Anthem BCBS Setting Facility Modifier None Typical Low $8,511.38 Median $11,220.18 Typical High $12,589.25 | Facility | None | $8,511.38 | $11,220.18 | $12,589.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $416.87 Median $4,570.88 Typical High $6,918.31 | Professional | None | $416.87 | $4,570.88 | $6,918.31 |
CareFirst Setting Professional Modifier None Typical Low $407.38 Median $457.09 Typical High $537.03 | Professional | None | $407.38 | $457.09 | $537.03 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $7,244.36 Typical High $14,454.40 | Facility | None | $630.96 | $7,244.36 | $14,454.40 |
Cigna Setting Professional Modifier None Typical Low $436.52 Median $870.96 Typical High $8,912.51 | Professional | None | $436.52 | $870.96 | $8,912.51 |
Kaiser Permanente Setting Professional Modifier None Typical Low $5,754.40 Median $6,760.83 Typical High $9,120.11 | Professional | None | $5,754.40 | $6,760.83 | $9,120.11 |
Medcost Setting Professional Modifier None Typical Low $10,964.78 Median $15,848.93 Typical High $15,848.93 | Professional | None | $10,964.78 | $15,848.93 | $15,848.93 |
Medcost Setting Facility Modifier None Typical Low $524.81 Median $851.14 Typical High $12,589.25 | Facility | None | $524.81 | $851.14 | $12,589.25 |
Medcost Setting Professional Modifier None Typical Low $1,023.29 Median $5,623.41 Typical High $10,000.00 | Professional | None | $1,023.29 | $5,623.41 | $10,000.00 |
Sentara Setting Facility Modifier None Typical Low $478.63 Median $2,398.83 Typical High $11,481.54 | Facility | None | $478.63 | $2,398.83 | $11,481.54 |
Sentara Setting Professional Modifier None Typical Low $6,760.83 Median $8,709.64 Typical High $11,481.54 | Professional | None | $6,760.83 | $8,709.64 | $11,481.54 |
United Setting Facility Modifier None Typical Low $2,570.40 Median $10,000.00 Typical High $25,118.86 | Facility | None | $2,570.40 | $10,000.00 | $25,118.86 |
United Setting Professional Modifier None Typical Low $398.11 Median $3,981.07 Typical High $11,481.54 | Professional | None | $398.11 | $3,981.07 | $11,481.54 |
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 $251.19 Median $457.09 Typical High $3,801.89 | Professional | 52 · Reduced service | $251.19 | $457.09 | $3,801.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $181.97 Typical High $1,548.82 | Professional | 53 · Discontinued | $100.00 | $181.97 | $1,548.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $691.83 Typical High $5,754.40 | Professional | 54 · Surgery only | $380.19 | $691.83 | $5,754.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $138.04 Typical High $1,148.15 | Professional | 55 · Aftercare only | $75.86 | $138.04 | $1,148.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $91.20 Typical High $758.58 | Professional | 56 · Pre-op care only | $50.12 | $91.20 | $758.58 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $354.81 Median $645.65 Typical High $5,370.32 | Professional | 78 · Unplanned return to OR | $354.81 | $645.65 | $5,370.32 |
Where Virginia sits
The same service costs 4.1 times more in Iowa than in Delaware. 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
IA $18,453DE $4,539
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.