How much rates vary
Facilitymedian $3,020 · 10th to 90th $550 to $9,550Professionalmedian $550 · 10th to 90th $437 to $776
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 $549.54 Median $4,786.30 Typical High $10,000.00 | Facility | None | $549.54 | $4,786.30 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $537.03 Median $549.54 Typical High $660.69 | Professional | None | $537.03 | $549.54 | $660.69 |
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 $489.78 Median $575.44 Typical High $691.83 | Professional | None | $489.78 | $575.44 | $691.83 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $724.44 Median $870.96 Typical High $1,047.13 | Professional | 50 · Both sides | $724.44 | $870.96 | $1,047.13 |
CareFirst Setting Professional Modifier None Typical Low $489.78 Median $537.03 Typical High $707.95 | Professional | None | $489.78 | $537.03 | $707.95 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $1,071.52 Typical High $2,187.76 | Facility | None | $478.63 | $1,071.52 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $436.52 Median $512.86 Typical High $758.58 | Professional | None | $436.52 | $512.86 | $758.58 |
Kaiser Permanente Setting Professional Modifier None Typical Low $512.86 Median $616.60 Typical High $794.33 | Professional | None | $512.86 | $616.60 | $794.33 |
Medcost Setting Professional Modifier None Typical Low $537.03 Median $660.69 Typical High $660.69 | Professional | None | $537.03 | $660.69 | $660.69 |
Medcost Setting Facility Modifier None Typical Low $537.03 Median $537.03 Typical High $912.01 | Facility | None | $537.03 | $537.03 | $912.01 |
Medcost Setting Professional Modifier None Typical Low $537.03 Median $562.34 Typical High $977.24 | Professional | None | $537.03 | $562.34 | $977.24 |
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 $446.68 Median $575.44 Typical High $1,202.26 | Professional | None | $446.68 | $575.44 | $1,202.26 |
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 $331.13 Median $446.68 Typical High $891.25 | Professional | None | $331.13 | $446.68 | $891.25 |
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 $275.42 Typical High $275.42 | Professional | 52 · Reduced service | $269.15 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $112.20 Typical High $112.20 | Professional | 53 · Discontinued | $107.15 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $416.87 Typical High $416.87 | Professional | 54 · Surgery only | $398.11 | $416.87 | $416.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $83.18 Typical High $83.18 | Professional | 55 · Aftercare only | $81.28 | $83.18 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $54.95 Typical High $54.95 | Professional | 56 · Pre-op care only | $53.70 | $54.95 | $54.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $389.05 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $371.54 | $389.05 | $389.05 |
Where Virginia sits
The same service costs 3.2 times more in Oklahoma 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
OK $5,349MD $1,661
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.