How much rates vary
Facilitymedian $2,692 · 10th to 90th $537 to $9,550Professionalmedian $525 · 10th to 90th $407 to $813
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 $575.44 Median $4,786.30 Typical High $9,332.54 | Facility | None | $575.44 | $4,786.30 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $389.05 Median $575.44 Typical High $831.76 | Professional | None | $389.05 | $575.44 | $831.76 |
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 $416.87 Median $501.19 Typical High $588.84 | Professional | None | $416.87 | $501.19 | $588.84 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $630.96 Median $758.58 Typical High $891.25 | Professional | 50 · Both sides | $630.96 | $758.58 | $891.25 |
CareFirst Setting Professional Modifier None Typical Low $426.58 Median $467.74 Typical High $549.54 | Professional | None | $426.58 | $467.74 | $549.54 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $1,230.27 Typical High $2,570.40 | Facility | None | $524.81 | $1,230.27 | $2,570.40 |
Cigna Setting Professional Modifier None Typical Low $407.38 Median $537.03 Typical High $741.31 | Professional | None | $407.38 | $537.03 | $741.31 |
Kaiser Permanente Setting Professional Modifier None Typical Low $575.44 Median $676.08 Typical High $851.14 | Professional | None | $575.44 | $676.08 | $851.14 |
Medcost Setting Professional Modifier None Typical Low $812.83 Median $851.14 Typical High $851.14 | Professional | None | $812.83 | $851.14 | $851.14 |
Medcost Setting Facility Modifier None Typical Low $389.05 Median $549.54 Typical High $1,047.13 | Facility | None | $389.05 | $549.54 | $1,047.13 |
Medcost Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $676.08 | Professional | None | $676.08 | $676.08 | $676.08 |
Sentara Setting Facility Modifier None Typical Low $398.11 Median $1,202.26 Typical High $8,709.64 | Facility | None | $398.11 | $1,202.26 | $8,709.64 |
Sentara Setting Professional Modifier None Typical Low $524.81 Median $691.83 Typical High $4,570.88 | Professional | None | $524.81 | $691.83 | $4,570.88 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $5,011.87 Typical High $13,182.57 | Facility | None | $1,230.27 | $5,011.87 | $13,182.57 |
United Setting Professional Modifier None Typical Low $346.74 Median $512.86 Typical High $912.01 | Professional | None | $346.74 | $512.86 | $912.01 |
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 $194.98 Median $288.40 Typical High $380.19 | Professional | 52 · Reduced service | $194.98 | $288.40 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $77.62 Median $114.82 Typical High $151.36 | Professional | 53 · Discontinued | $77.62 | $114.82 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $295.12 Median $426.58 Typical High $575.44 | Professional | 54 · Surgery only | $295.12 | $426.58 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $87.10 Typical High $114.82 | Professional | 55 · Aftercare only | $58.88 | $87.10 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $57.54 Typical High $75.86 | Professional | 56 · Pre-op care only | $38.90 | $57.54 | $75.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $275.42 Median $398.11 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $275.42 | $398.11 | $537.03 |
Where Virginia sits
The same service costs 4.0 times more in Oklahoma than in West Virginia. 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 $5,056WV $1,262
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.