How much rates vary
Facilitymedian $646 · 10th to 90th $155 to $4,074Professionalmedian $347 · 10th to 90th $275 to $490
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 $281.84 Median $4,073.80 Typical High $10,000.00 | Facility | None | $281.84 | $4,073.80 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $275.42 Median $416.87 Typical High $478.63 | Professional | None | $275.42 | $416.87 | $478.63 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,698.24 Median $2,398.83 Typical High $2,951.21 | Facility | None | $1,698.24 | $2,398.83 | $2,951.21 |
Anthem BCBS Setting Professional Modifier None Typical Low $302.00 Median $363.08 Typical High $426.58 | Professional | None | $302.00 | $363.08 | $426.58 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $457.09 Median $537.03 Typical High $630.96 | Professional | 50 · Both sides | $457.09 | $537.03 | $630.96 |
CareFirst Setting Professional Modifier None Typical Low $309.03 Median $338.84 Typical High $354.81 | Professional | None | $309.03 | $338.84 | $354.81 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $181.97 Typical High $338.84 | Facility | None | $50.12 | $181.97 | $338.84 |
Cigna Setting Professional Modifier None Typical Low $288.40 Median $323.59 Typical High $457.09 | Professional | None | $288.40 | $323.59 | $457.09 |
Kaiser Permanente Setting Professional Modifier None Typical Low $323.59 Median $380.19 Typical High $478.63 | Professional | None | $323.59 | $380.19 | $478.63 |
Medcost Setting Professional Modifier None Typical Low $436.52 Median $562.34 Typical High $562.34 | Professional | None | $436.52 | $562.34 | $562.34 |
Medcost Setting Facility Modifier None Typical Low $275.42 Median $371.54 Typical High $602.56 | Facility | None | $275.42 | $371.54 | $602.56 |
Medcost Setting Professional Modifier None Typical Low $371.54 Median $371.54 Typical High $371.54 | Professional | None | $371.54 | $371.54 | $371.54 |
Sentara Setting Facility Modifier None Typical Low $275.42 Median $512.86 Typical High $2,454.71 | Facility | None | $275.42 | $512.86 | $2,454.71 |
Sentara Setting Professional Modifier None Typical Low $323.59 Median $436.52 Typical High $1,174.90 | Professional | None | $323.59 | $436.52 | $1,174.90 |
United Setting Facility Modifier None Typical Low $100.00 Median $660.69 Typical High $2,041.74 | Facility | None | $100.00 | $660.69 | $2,041.74 |
United Setting Professional Modifier None Typical Low $229.09 Median $323.59 Typical High $537.03 | Professional | None | $229.09 | $323.59 | $537.03 |
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 $138.04 Median $208.93 Typical High $213.80 | Professional | 52 · Reduced service | $138.04 | $208.93 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $83.18 Typical High $85.11 | Professional | 53 · Discontinued | $54.95 | $83.18 | $85.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $309.03 Typical High $316.23 | Professional | 54 · Surgery only | $208.93 | $309.03 | $316.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $61.66 Typical High $63.10 | Professional | 55 · Aftercare only | $41.69 | $61.66 | $63.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $41.69 Typical High $42.66 | Professional | 56 · Pre-op care only | $27.54 | $41.69 | $42.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $194.98 Median $288.40 Typical High $295.12 | Professional | 78 · Unplanned return to OR | $194.98 | $288.40 | $295.12 |
Where Virginia sits
The same service costs 7.4 times more in Hawaii than in Florida. 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
HI $3,255FL $440
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.