How much rates vary
Facilitymedian $3,548 · 10th to 90th $776 to $9,550Professionalmedian $776 · 10th to 90th $631 to $1,230
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 $776.25 Median $4,786.30 Typical High $14,125.38 | Facility | None | $776.25 | $4,786.30 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $741.31 Median $758.58 Typical High $3,162.28 | Professional | None | $741.31 | $758.58 | $3,162.28 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,677.35 Median $6,456.54 Typical High $7,244.36 | Facility | None | $4,677.35 | $6,456.54 | $7,244.36 |
Anthem BCBS Setting Professional Modifier None Typical Low $630.96 Median $758.58 Typical High $977.24 | Professional | None | $630.96 | $758.58 | $977.24 |
CareFirst Setting Professional Modifier None Typical Low $660.69 Median $741.31 Typical High $977.24 | Professional | None | $660.69 | $741.31 | $977.24 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $1,949.84 Typical High $4,677.35 | Facility | None | $524.81 | $1,949.84 | $4,677.35 |
Cigna Setting Professional Modifier None Typical Low $660.69 Median $794.33 Typical High $1,202.26 | Professional | None | $660.69 | $794.33 | $1,202.26 |
Kaiser Permanente Setting Professional Modifier None Typical Low $602.56 Median $707.95 Typical High $891.25 | Professional | None | $602.56 | $707.95 | $891.25 |
Medcost Setting Facility Modifier None Typical Low $758.58 Median $912.01 Typical High $1,258.93 | Facility | None | $758.58 | $912.01 | $1,258.93 |
Medcost Setting Professional Modifier None Typical Low $933.25 Median $933.25 Typical High $933.25 | Professional | None | $933.25 | $933.25 | $933.25 |
Sentara Setting Facility Modifier None Typical Low $676.08 Median $1,778.28 Typical High $8,709.64 | Facility | None | $676.08 | $1,778.28 | $8,709.64 |
Sentara Setting Professional Modifier None Typical Low $691.83 Median $912.01 Typical High $4,570.88 | Professional | None | $691.83 | $912.01 | $4,570.88 |
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 $562.34 Median $912.01 Typical High $1,380.38 | Professional | None | $562.34 | $912.01 | $1,380.38 |
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 $354.81 Median $380.19 Typical High $389.05 | Professional | 52 · Reduced service | $354.81 | $380.19 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $151.36 Typical High $154.88 | Professional | 53 · Discontinued | $144.54 | $151.36 | $154.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $575.44 Typical High $588.84 | Professional | 54 · Surgery only | $537.03 | $575.44 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $114.82 Typical High $117.49 | Professional | 55 · Aftercare only | $107.15 | $114.82 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $75.86 Typical High $77.62 | Professional | 56 · Pre-op care only | $72.44 | $75.86 | $77.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $537.03 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $501.19 | $537.03 | $549.54 |
Where Virginia sits
The same service costs 4.2 times more in Oklahoma 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
OK $7,369KY $1,773
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.