How much rates vary
Facilitymedian $3,388 · 10th to 90th $589 to $10,965Professionalmedian $513 · 10th to 90th $407 to $813
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 $537.03 Median $3,801.89 Typical High $10,471.29 | Facility | None | $537.03 | $3,801.89 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $489.78 Median $537.03 Typical High $2,511.89 | Professional | None | $489.78 | $537.03 | $2,511.89 |
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 $407.38 Median $478.63 Typical High $616.60 | Professional | None | $407.38 | $478.63 | $616.60 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $602.56 Median $724.44 Typical High $933.25 | Professional | 50 · Both sides | $602.56 | $724.44 | $933.25 |
CareFirst Setting Professional Modifier None Typical Low $416.87 Median $467.74 Typical High $3,890.45 | Professional | None | $416.87 | $467.74 | $3,890.45 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $1,778.28 Typical High $3,311.31 | Facility | None | $645.65 | $1,778.28 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $426.58 Median $512.86 Typical High $758.58 | Professional | None | $426.58 | $512.86 | $758.58 |
Kaiser Permanente Setting Professional Modifier None Typical Low $380.19 Median $457.09 Typical High $562.34 | Professional | None | $380.19 | $457.09 | $562.34 |
Medcost Setting Professional Modifier None Typical Low $575.44 Median $724.44 Typical High $724.44 | Professional | None | $575.44 | $724.44 | $724.44 |
Medcost Setting Facility Modifier None Typical Low $537.03 Median $691.83 Typical High $891.25 | Facility | None | $537.03 | $691.83 | $891.25 |
Medcost Setting Professional Modifier None Typical Low $630.96 Median $630.96 Typical High $630.96 | Professional | None | $630.96 | $630.96 | $630.96 |
Sentara Setting Facility Modifier None Typical Low $407.38 Median $1,819.70 Typical High $10,232.93 | Facility | None | $407.38 | $1,819.70 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $436.52 Median $602.56 Typical High $6,025.60 | Professional | None | $436.52 | $602.56 | $6,025.60 |
United Setting Facility Modifier None Typical Low $1,548.82 Median $6,760.83 Typical High $16,595.87 | Facility | None | $1,548.82 | $6,760.83 | $16,595.87 |
United Setting Professional Modifier None Typical Low $354.81 Median $588.84 Typical High $870.96 | Professional | None | $354.81 | $588.84 | $870.96 |
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 $234.42 Median $269.15 Typical High $269.15 | Professional | 52 · Reduced service | $234.42 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $109.65 Typical High $109.65 | Professional | 53 · Discontinued | $93.33 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $407.38 Typical High $407.38 | Professional | 54 · Surgery only | $354.81 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $81.28 Typical High $81.28 | Professional | 55 · Aftercare only | $70.79 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $53.70 Typical High $53.70 | Professional | 56 · Pre-op care only | $46.77 | $53.70 | $53.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $331.13 Median $380.19 Typical High $380.19 | Professional | 78 · Unplanned return to OR | $331.13 | $380.19 | $380.19 |
Where Virginia sits
The same service costs 5.5 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 $7,406MT $1,352
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.