How much rates vary
Facilitymedian $2,570 · 10th to 90th $550 to $9,550Professionalmedian $575 · 10th to 90th $447 to $1,000
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 $812.83 Median $3,801.89 Typical High $9,332.54 | Facility | None | $812.83 | $3,801.89 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $501.19 Median $776.25 Typical High $851.14 | Professional | None | $501.19 | $776.25 | $851.14 |
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 $457.09 Median $537.03 Typical High $660.69 | Professional | None | $457.09 | $537.03 | $660.69 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $676.08 Median $812.83 Typical High $977.24 | Professional | 50 · Both sides | $676.08 | $812.83 | $977.24 |
CareFirst Setting Professional Modifier None Typical Low $467.74 Median $524.81 Typical High $676.08 | Professional | None | $467.74 | $524.81 | $676.08 |
Cigna Setting Facility Modifier None Typical Low $346.74 Median $977.24 Typical High $1,862.09 | Facility | None | $346.74 | $977.24 | $1,862.09 |
Cigna Setting Professional Modifier None Typical Low $446.68 Median $707.95 Typical High $1,096.48 | Professional | None | $446.68 | $707.95 | $1,096.48 |
Kaiser Permanente Setting Professional Modifier None Typical Low $831.76 Median $1,000.00 Typical High $1,258.93 | Professional | None | $831.76 | $1,000.00 | $1,258.93 |
Medcost Setting Professional Modifier None Typical Low $851.14 Median $1,096.48 Typical High $1,096.48 | Professional | None | $851.14 | $1,096.48 | $1,096.48 |
Medcost Setting Facility Modifier None Typical Low $549.54 Median $851.14 Typical High $1,412.54 | Facility | None | $549.54 | $851.14 | $1,412.54 |
Medcost Setting Professional Modifier None Typical Low $524.81 Median $645.65 Typical High $851.14 | Professional | None | $524.81 | $645.65 | $851.14 |
Sentara Setting Facility Modifier None Typical Low $436.52 Median $1,737.80 Typical High $8,709.64 | Facility | None | $436.52 | $1,737.80 | $8,709.64 |
Sentara Setting Professional Modifier None Typical Low $630.96 Median $870.96 Typical High $1,905.46 | Professional | None | $630.96 | $870.96 | $1,905.46 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $4,897.79 Typical High $13,182.57 | Facility | None | $1,230.27 | $4,897.79 | $13,182.57 |
United Setting Professional Modifier None Typical Low $354.81 Median $630.96 Typical High $1,174.90 | Professional | None | $354.81 | $630.96 | $1,174.90 |
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 $251.19 Median $338.84 Typical High $426.58 | Professional | 52 · Reduced service | $251.19 | $338.84 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $134.90 Typical High $173.78 | Professional | 53 · Discontinued | $100.00 | $134.90 | $173.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $501.19 Typical High $645.65 | Professional | 54 · Surgery only | $371.54 | $501.19 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $100.00 Typical High $128.82 | Professional | 55 · Aftercare only | $74.13 | $100.00 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $67.61 Typical High $85.11 | Professional | 56 · Pre-op care only | $50.12 | $67.61 | $85.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $346.74 Median $467.74 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $346.74 | $467.74 | $602.56 |
Where Virginia sits
The same service costs 3.0 times more in Colorado than in Maryland. 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
CO $5,106MD $1,697
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.