How much rates vary
Facilitymedian $2,138 · 10th to 90th $295 to $9,333Professionalmedian $251 · 10th to 90th $178 to $603
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 $269.15 Median $912.01 Typical High $8,317.64 | Facility | None | $269.15 | $912.01 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $190.55 Median $457.09 Typical High $602.56 | Professional | None | $190.55 | $457.09 | $602.56 |
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 $177.83 Median $213.80 Typical High $257.04 | Professional | None | $177.83 | $213.80 | $257.04 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $269.15 Median $323.59 Typical High $389.05 | Professional | 50 · Both sides | $269.15 | $323.59 | $389.05 |
CareFirst Setting Professional Modifier None Typical Low $177.83 Median $199.53 Typical High $257.04 | Professional | None | $177.83 | $199.53 | $257.04 |
Cigna Setting Facility Modifier None Typical Low $389.05 Median $1,071.52 Typical High $1,862.09 | Facility | None | $389.05 | $1,071.52 | $1,862.09 |
Cigna Setting Professional Modifier None Typical Low $186.21 Median $380.19 Typical High $645.65 | Professional | None | $186.21 | $380.19 | $645.65 |
Kaiser Permanente Setting Professional Modifier None Typical Low $446.68 Median $537.03 Typical High $691.83 | Professional | None | $446.68 | $537.03 | $691.83 |
Medcost Setting Professional Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $1,000.00 | Professional | None | $1,000.00 | $1,000.00 | $1,000.00 |
Medcost Setting Facility Modifier None Typical Low $251.19 Median $416.87 Typical High $758.58 | Facility | None | $251.19 | $416.87 | $758.58 |
Medcost Setting Professional Modifier None Typical Low $190.55 Median $257.04 Typical High $602.56 | Professional | None | $190.55 | $257.04 | $602.56 |
Sentara Setting Facility Modifier None Typical Low $213.80 Median $1,023.29 Typical High $8,709.64 | Facility | None | $213.80 | $1,023.29 | $8,709.64 |
Sentara Setting Professional Modifier None Typical Low $436.52 Median $562.34 Typical High $1,047.13 | Professional | None | $436.52 | $562.34 | $1,047.13 |
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 $162.18 Median $346.74 Typical High $707.95 | Professional | None | $162.18 | $346.74 | $707.95 |
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 $95.50 Median $177.83 Typical High $234.42 | Professional | 52 · Reduced service | $95.50 | $177.83 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $70.79 Typical High $93.33 | Professional | 53 · Discontinued | $38.02 | $70.79 | $93.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $263.03 Typical High $346.74 | Professional | 54 · Surgery only | $144.54 | $263.03 | $346.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $52.48 Typical High $69.18 | Professional | 55 · Aftercare only | $28.84 | $52.48 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $35.48 Typical High $46.77 | Professional | 56 · Pre-op care only | $19.05 | $35.48 | $46.77 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $134.90 Median $245.47 Typical High $323.59 | Professional | 78 · Unplanned return to OR | $134.90 | $245.47 | $323.59 |
Where Virginia sits
The same service costs 4.6 times more in Colorado 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
CO $4,728MT $1,029
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.