How much rates vary
Facilitymedian $11,482 · 10th to 90th $603 to $53,703Professionalmedian $603 · 10th to 90th $490 to $977
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 $724.44 Median $4,073.80 Typical High $14,125.38 | Facility | None | $724.44 | $4,073.80 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $562.34 Median $575.44 Typical High $2,570.40 | Professional | None | $562.34 | $575.44 | $2,570.40 |
Anthem BCBS Setting Facility Modifier None Typical Low $48,977.88 Median $63,095.73 Typical High $67,608.30 | Facility | None | $48,977.88 | $63,095.73 | $67,608.30 |
Anthem BCBS Setting Professional Modifier None Typical Low $501.19 Median $602.56 Typical High $776.25 | Professional | None | $501.19 | $602.56 | $776.25 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $758.58 Median $912.01 Typical High $1,148.15 | Professional | 50 · Both sides | $758.58 | $912.01 | $1,148.15 |
CareFirst Setting Professional Modifier None Typical Low $489.78 Median $537.03 Typical High $4,365.16 | Professional | None | $489.78 | $537.03 | $4,365.16 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $26,302.68 Typical High $50,118.72 | Facility | None | $478.63 | $26,302.68 | $50,118.72 |
Cigna Setting Professional Modifier None Typical Low $501.19 Median $588.84 Typical High $891.25 | Professional | None | $501.19 | $588.84 | $891.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $524.81 Median $630.96 Typical High $776.25 | Professional | None | $524.81 | $630.96 | $776.25 |
Medcost Setting Professional Modifier None Typical Low $660.69 Median $831.76 Typical High $831.76 | Professional | None | $660.69 | $831.76 | $831.76 |
Medcost Setting Facility Modifier None Typical Low $575.44 Median $794.33 Typical High $954.99 | Facility | None | $575.44 | $794.33 | $954.99 |
Medcost Setting Professional Modifier None Typical Low $776.25 Median $776.25 Typical High $776.25 | Professional | None | $776.25 | $776.25 | $776.25 |
Sentara Setting Facility Modifier None Typical Low $467.74 Median $1,905.46 Typical High $42,657.95 | Facility | None | $467.74 | $1,905.46 | $42,657.95 |
Sentara Setting Professional Modifier None Typical Low $489.78 Median $691.83 Typical High $7,413.10 | Professional | None | $489.78 | $691.83 | $7,413.10 |
United Setting Facility Modifier None Typical Low $10,000.00 Median $23,988.33 Typical High $64,565.42 | Facility | None | $10,000.00 | $23,988.33 | $64,565.42 |
United Setting Professional Modifier None Typical Low $426.58 Median $676.08 Typical High $1,047.13 | Professional | None | $426.58 | $676.08 | $1,047.13 |
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 $269.15 Median $288.40 Typical High $288.40 | Professional | 52 · Reduced service | $269.15 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $117.49 Typical High $117.49 | Professional | 53 · Discontinued | $107.15 | $117.49 | $117.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $436.52 Typical High $436.52 | Professional | 54 · Surgery only | $407.38 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $87.10 Typical High $87.10 | Professional | 55 · Aftercare only | $81.28 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $57.54 Typical High $57.54 | Professional | 56 · Pre-op care only | $53.70 | $57.54 | $57.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $380.19 Median $407.38 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $380.19 | $407.38 | $407.38 |
Where Virginia sits
The same service costs 24.6 times more in Alaska 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
AK $43,875MT $1,787
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.