How much rates vary
Facilitymedian $5,129 · 10th to 90th $513 to $13,183Professionalmedian $457 · 10th to 90th $363 to $741
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 $478.63 Median $5,370.32 Typical High $12,589.25 | Facility | None | $478.63 | $5,370.32 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $446.68 Typical High $1,548.82 | Professional | None | $407.38 | $446.68 | $1,548.82 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,011.87 Median $6,760.83 Typical High $9,549.93 | Facility | None | $5,011.87 | $6,760.83 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $363.08 Median $426.58 Typical High $549.54 | Professional | None | $363.08 | $426.58 | $549.54 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $537.03 Median $645.65 Typical High $831.76 | Professional | 50 · Both sides | $537.03 | $645.65 | $831.76 |
CareFirst Setting Professional Modifier None Typical Low $371.54 Median $416.87 Typical High $4,786.30 | Professional | None | $371.54 | $416.87 | $4,786.30 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $2,754.23 Typical High $5,128.61 | Facility | None | $645.65 | $2,754.23 | $5,128.61 |
Cigna Setting Professional Modifier None Typical Low $380.19 Median $446.68 Typical High $691.83 | Professional | None | $380.19 | $446.68 | $691.83 |
Kaiser Permanente Setting Professional Modifier None Typical Low $331.13 Median $389.05 Typical High $489.78 | Professional | None | $331.13 | $389.05 | $489.78 |
Medcost Setting Professional Modifier None Typical Low $588.84 Median $741.31 Typical High $741.31 | Professional | None | $588.84 | $741.31 | $741.31 |
Medcost Setting Facility Modifier None Typical Low $446.68 Median $645.65 Typical High $724.44 | Facility | None | $446.68 | $645.65 | $724.44 |
Medcost Setting Professional Modifier None Typical Low $588.84 Median $588.84 Typical High $588.84 | Professional | None | $588.84 | $588.84 | $588.84 |
Sentara Setting Facility Modifier None Typical Low $416.87 Median $1,819.70 Typical High $10,232.93 | Facility | None | $416.87 | $1,819.70 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $407.38 Median $537.03 Typical High $7,762.47 | Professional | None | $407.38 | $537.03 | $7,762.47 |
United Setting Facility Modifier None Typical Low $2,137.96 Median $8,511.38 Typical High $20,417.38 | Facility | None | $2,137.96 | $8,511.38 | $20,417.38 |
United Setting Professional Modifier None Typical Low $323.59 Median $524.81 Typical High $794.33 | Professional | None | $323.59 | $524.81 | $794.33 |
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 $204.17 Median $223.87 Typical High $223.87 | Professional | 52 · Reduced service | $204.17 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $89.13 Typical High $89.13 | Professional | 53 · Discontinued | $81.28 | $89.13 | $89.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $331.13 Typical High $331.13 | Professional | 54 · Surgery only | $309.03 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $66.07 Typical High $66.07 | Professional | 55 · Aftercare only | $61.66 | $66.07 | $66.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $44.67 Typical High $44.67 | Professional | 56 · Pre-op care only | $40.74 | $44.67 | $44.67 |
Where Virginia sits
The same service costs 7.3 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 $8,816MT $1,205
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.