How much rates vary
Facilitymedian $3,467 · 10th to 90th $468 to $10,000Professionalmedian $407 · 10th to 90th $324 to $661
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 $436.52 Median $4,786.30 Typical High $10,964.78 | Facility | None | $436.52 | $4,786.30 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $371.54 Median $398.11 Typical High $977.24 | Professional | None | $371.54 | $398.11 | $977.24 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,677.35 Median $6,025.60 Typical High $7,244.36 | Facility | None | $4,677.35 | $6,025.60 | $7,244.36 |
Anthem BCBS Setting Professional Modifier None Typical Low $323.59 Median $389.05 Typical High $501.19 | Professional | None | $323.59 | $389.05 | $501.19 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $489.78 Median $588.84 Typical High $741.31 | Professional | 50 · Both sides | $489.78 | $588.84 | $741.31 |
CareFirst Setting Professional Modifier None Typical Low $338.84 Median $371.54 Typical High $4,786.30 | Professional | None | $338.84 | $371.54 | $4,786.30 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $1,819.70 Typical High $3,311.31 | Facility | None | $645.65 | $1,819.70 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $338.84 Median $407.38 Typical High $616.60 | Professional | None | $338.84 | $407.38 | $616.60 |
Kaiser Permanente Setting Professional Modifier None Typical Low $302.00 Median $354.81 Typical High $446.68 | Professional | None | $302.00 | $354.81 | $446.68 |
Medcost Setting Professional Modifier None Typical Low $512.86 Median $630.96 Typical High $630.96 | Professional | None | $512.86 | $630.96 | $630.96 |
Medcost Setting Facility Modifier None Typical Low $398.11 Median $562.34 Typical High $660.69 | Facility | None | $398.11 | $562.34 | $660.69 |
Medcost Setting Professional Modifier None Typical Low $501.19 Median $501.19 Typical High $501.19 | Professional | None | $501.19 | $501.19 | $501.19 |
Sentara Setting Facility Modifier None Typical Low $363.08 Median $1,659.59 Typical High $8,709.64 | Facility | None | $363.08 | $1,659.59 | $8,709.64 |
Sentara Setting Professional Modifier None Typical Low $363.08 Median $478.63 Typical High $5,128.61 | Professional | None | $363.08 | $478.63 | $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 $295.12 Median $478.63 Typical High $724.44 | Professional | None | $295.12 | $478.63 | $724.44 |
5 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 $199.53 Typical High $199.53 | Professional | 52 · Reduced service | $186.21 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $81.28 Typical High $81.28 | Professional | 53 · Discontinued | $74.13 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $302.00 Typical High $302.00 | Professional | 54 · Surgery only | $275.42 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $60.26 Typical High $60.26 | Professional | 55 · Aftercare only | $54.95 | $60.26 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $39.81 Typical High $39.81 | Professional | 56 · Pre-op care only | $37.15 | $39.81 | $39.81 |
Where Virginia sits
The same service costs 6.1 times more in Wisconsin 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
WI $6,592MT $1,087
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.