How much rates vary
Facilitymedian $5,754 · 10th to 90th $977 to $15,136Professionalmedian $813 · 10th to 90th $661 to $1,514
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 $1,230.27 Median $5,495.41 Typical High $12,882.50 | Facility | None | $1,230.27 | $5,495.41 | $12,882.50 |
Aetna Setting Professional Modifier None Typical Low $741.31 Median $977.24 Typical High $3,235.94 | Professional | None | $741.31 | $977.24 | $3,235.94 |
Anthem BCBS Setting Facility Modifier None Typical Low $10,964.78 Median $13,803.84 Typical High $15,848.93 | Facility | None | $10,964.78 | $13,803.84 | $15,848.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $645.65 Median $776.25 Typical High $1,000.00 | Professional | None | $645.65 | $776.25 | $1,000.00 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $977.24 Median $1,174.90 Typical High $1,479.11 | Professional | 50 · Both sides | $977.24 | $1,174.90 | $1,479.11 |
CareFirst Setting Professional Modifier None Typical Low $676.08 Median $741.31 Typical High $10,715.19 | Professional | None | $676.08 | $741.31 | $10,715.19 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $4,786.30 Typical High $9,549.93 | Facility | None | $512.86 | $4,786.30 | $9,549.93 |
Cigna Setting Professional Modifier None Typical Low $676.08 Median $954.99 Typical High $1,445.44 | Professional | None | $676.08 | $954.99 | $1,445.44 |
Kaiser Permanente Setting Professional Modifier None Typical Low $616.60 Median $724.44 Typical High $912.01 | Professional | None | $616.60 | $724.44 | $912.01 |
Medcost Setting Professional Modifier None Typical Low $1,122.02 Median $1,412.54 Typical High $1,412.54 | Professional | None | $1,122.02 | $1,412.54 | $1,412.54 |
Medcost Setting Facility Modifier None Typical Low $977.24 Median $1,288.25 Typical High $1,621.81 | Facility | None | $977.24 | $1,288.25 | $1,621.81 |
Medcost Setting Professional Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $1,202.26 | Professional | None | $1,202.26 | $1,202.26 | $1,202.26 |
Sentara Setting Facility Modifier None Typical Low $812.83 Median $2,344.23 Typical High $13,803.84 | Facility | None | $812.83 | $2,344.23 | $13,803.84 |
Sentara Setting Professional Modifier None Typical Low $812.83 Median $1,174.90 Typical High $7,413.10 | Professional | None | $812.83 | $1,174.90 | $7,413.10 |
United Setting Facility Modifier None Typical Low $1,995.26 Median $8,511.38 Typical High $20,417.38 | Facility | None | $1,995.26 | $8,511.38 | $20,417.38 |
United Setting Professional Modifier None Typical Low $724.44 Median $1,148.15 Typical High $1,778.28 | Professional | None | $724.44 | $1,148.15 | $1,778.28 |
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 $371.54 Median $489.78 Typical High $489.78 | Professional | 52 · Reduced service | $371.54 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $199.53 Typical High $199.53 | Professional | 53 · Discontinued | $147.91 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $741.31 Typical High $741.31 | Professional | 54 · Surgery only | $549.54 | $741.31 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $147.91 Typical High $147.91 | Professional | 55 · Aftercare only | $112.20 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $97.72 Typical High $97.72 | Professional | 56 · Pre-op care only | $74.13 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $691.83 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $512.86 | $691.83 | $691.83 |
Where Virginia sits
The same service costs 6.6 times more in Colorado 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
CO $14,612KY $2,222
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.