How much rates vary
Facilitymedian $2,570 · 10th to 90th $309 to $9,550Professionalmedian $389 · 10th to 90th $214 to $631
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 $309.03 Median $602.56 Typical High $9,332.54 | Facility | None | $309.03 | $602.56 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $186.21 Median $380.19 Typical High $707.95 | Professional | None | $186.21 | $380.19 | $707.95 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,884.03 Median $3,715.35 Typical High $4,265.80 | Facility | None | $2,884.03 | $3,715.35 | $4,265.80 |
Anthem BCBS Setting Professional Modifier None Typical Low $218.78 Median $380.19 Typical High $562.34 | Professional | None | $218.78 | $380.19 | $562.34 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $138.04 Median $245.47 Typical High $354.81 | Professional | 62 · Two surgeons | $138.04 | $245.47 | $354.81 |
CareFirst Setting Professional Modifier None Typical Low $213.80 Median $234.42 Typical High $3,162.28 | Professional | None | $213.80 | $234.42 | $3,162.28 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $1,778.28 Typical High $3,311.31 | Facility | None | $524.81 | $1,778.28 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $213.80 Median $389.05 Typical High $630.96 | Professional | None | $213.80 | $389.05 | $630.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $186.21 Median $467.74 Typical High $575.44 | Professional | None | $186.21 | $467.74 | $575.44 |
Medcost Setting Professional Modifier None Typical Low $426.58 Median $537.03 Typical High $537.03 | Professional | None | $426.58 | $537.03 | $537.03 |
Medcost Setting Facility Modifier None Typical Low $251.19 Median $407.38 Typical High $660.69 | Facility | None | $251.19 | $407.38 | $660.69 |
Medcost Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $457.09 | Professional | None | $457.09 | $457.09 | $457.09 |
Sentara Setting Facility Modifier None Typical Low $229.09 Median $1,023.29 Typical High $8,709.64 | Facility | None | $229.09 | $1,023.29 | $8,709.64 |
Sentara Setting Professional Modifier None Typical Low $323.59 Median $501.19 Typical High $4,570.88 | Professional | None | $323.59 | $501.19 | $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 $208.93 Median $389.05 Typical High $691.83 | Professional | None | $208.93 | $389.05 | $691.83 |
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 $91.20 Median $147.91 Typical High $204.17 | Professional | 52 · Reduced service | $91.20 | $147.91 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $58.88 Typical High $81.28 | Professional | 53 · Discontinued | $36.31 | $58.88 | $81.28 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $218.78 Typical High $302.00 | Professional | 54 · Surgery only | $138.04 | $218.78 | $302.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $43.65 Typical High $61.66 | Professional | 55 · Aftercare only | $27.54 | $43.65 | $61.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $29.51 Typical High $40.74 | Professional | 56 · Pre-op care only | $18.20 | $29.51 | $40.74 |
Where Virginia sits
The same service costs 5.9 times more in Oklahoma than in West Virginia. 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 $4,893WV $835
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.