How much rates vary
Facilitymedian $1,862 · 10th to 90th $380 to $6,457Professionalmedian $407 · 10th to 90th $309 to $741
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 $512.86 Median $2,818.38 Typical High $9,332.54 | Facility | None | $512.86 | $2,818.38 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $363.08 Median $512.86 Typical High $831.76 | Professional | None | $363.08 | $512.86 | $831.76 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,677.35 Median $6,456.54 Typical High $7,244.36 | Facility | None | $4,677.35 | $6,456.54 | $7,244.36 |
Anthem BCBS Setting Professional Modifier None Typical Low $309.03 Median $371.54 Typical High $467.74 | Professional | None | $309.03 | $371.54 | $467.74 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $467.74 Median $549.54 Typical High $707.95 | Professional | 50 · Both sides | $467.74 | $549.54 | $707.95 |
CareFirst Setting Professional Modifier None Typical Low $309.03 Median $346.74 Typical High $2,818.38 | Professional | None | $309.03 | $346.74 | $2,818.38 |
Cigna Setting Facility Modifier None Typical Low $346.74 Median $1,258.93 Typical High $2,344.23 | Facility | None | $346.74 | $1,258.93 | $2,344.23 |
Cigna Setting Professional Modifier None Typical Low $331.13 Median $467.74 Typical High $707.95 | Professional | None | $331.13 | $467.74 | $707.95 |
Kaiser Permanente Setting Professional Modifier None Typical Low $295.12 Median $549.54 Typical High $676.08 | Professional | None | $295.12 | $549.54 | $676.08 |
Medcost Setting Professional Modifier None Typical Low $489.78 Median $616.60 Typical High $616.60 | Professional | None | $489.78 | $616.60 | $616.60 |
Medcost Setting Facility Modifier None Typical Low $363.08 Median $512.86 Typical High $831.76 | Facility | None | $363.08 | $512.86 | $831.76 |
Medcost Setting Professional Modifier None Typical Low $549.54 Median $549.54 Typical High $549.54 | Professional | None | $549.54 | $549.54 | $549.54 |
Sentara Setting Facility Modifier None Typical Low $295.12 Median $1,071.52 Typical High $3,630.78 | Facility | None | $295.12 | $1,071.52 | $3,630.78 |
Sentara Setting Professional Modifier None Typical Low $323.59 Median $588.84 Typical High $2,187.76 | Professional | None | $323.59 | $588.84 | $2,187.76 |
United Setting Facility Modifier None Typical Low $588.84 Median $2,187.76 Typical High $5,888.44 | Facility | None | $588.84 | $2,187.76 | $5,888.44 |
United Setting Professional Modifier None Typical Low $281.84 Median $489.78 Typical High $812.83 | Professional | None | $281.84 | $489.78 | $812.83 |
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 $181.97 Median $204.17 Typical High $269.15 | Professional | 52 · Reduced service | $181.97 | $204.17 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $81.28 Typical High $107.15 | Professional | 53 · Discontinued | $72.44 | $81.28 | $107.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $302.00 Typical High $398.11 | Professional | 54 · Surgery only | $269.15 | $302.00 | $398.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $61.66 Typical High $79.43 | Professional | 55 · Aftercare only | $53.70 | $61.66 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $40.74 Typical High $53.70 | Professional | 56 · Pre-op care only | $36.31 | $40.74 | $53.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $251.19 Median $281.84 Typical High $371.54 | Professional | 78 · Unplanned return to OR | $251.19 | $281.84 | $371.54 |
Where Virginia sits
The same service costs 5.0 times more in Colorado than in Delaware. 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 $5,773DE $1,161
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.