How much rates vary
Facilitymedian $5,495 · 10th to 90th $1,413 to $14,791Professionalmedian $1,585 · 10th to 90th $1,288 to $2,455
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 $1,949.84 Median $5,623.41 Typical High $15,488.17 | Facility | None | $1,949.84 | $5,623.41 | $15,488.17 |
Aetna Setting Professional Modifier None Typical Low $1,548.82 Median $1,548.82 Typical High $4,365.16 | Professional | None | $1,548.82 | $1,548.82 | $4,365.16 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,165.95 Median $7,413.10 Typical High $9,549.93 | Facility | None | $6,165.95 | $7,413.10 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,318.26 Median $1,584.89 Typical High $1,995.26 | Professional | None | $1,318.26 | $1,584.89 | $1,995.26 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,995.26 Median $2,344.23 Typical High $3,019.95 | Professional | 50 · Both sides | $1,995.26 | $2,344.23 | $3,019.95 |
CareFirst Setting Professional Modifier None Typical Low $1,318.26 Median $1,479.11 Typical High $8,511.38 | Professional | None | $1,318.26 | $1,479.11 | $8,511.38 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $3,019.95 Typical High $5,754.40 | Facility | None | $1,000.00 | $3,019.95 | $5,754.40 |
Cigna Setting Professional Modifier None Typical Low $1,380.38 Median $1,584.89 Typical High $2,344.23 | Professional | None | $1,380.38 | $1,584.89 | $2,344.23 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,258.93 Median $1,513.56 Typical High $1,862.09 | Professional | None | $1,258.93 | $1,513.56 | $1,862.09 |
Medcost Setting Professional Modifier None Typical Low $1,737.80 Median $2,137.96 Typical High $2,137.96 | Professional | None | $1,737.80 | $2,137.96 | $2,137.96 |
Medcost Setting Facility Modifier None Typical Low $1,548.82 Median $1,778.28 Typical High $2,570.40 | Facility | None | $1,548.82 | $1,778.28 | $2,570.40 |
Medcost Setting Professional Modifier None Typical Low $1,698.24 Median $1,698.24 Typical High $1,698.24 | Professional | None | $1,698.24 | $1,698.24 | $1,698.24 |
Sentara Setting Facility Modifier None Typical Low $1,023.29 Median $2,570.40 Typical High $10,232.93 | Facility | None | $1,023.29 | $2,570.40 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $1,288.25 Median $1,778.28 Typical High $7,762.47 | Professional | None | $1,288.25 | $1,778.28 | $7,762.47 |
United Setting Facility Modifier None Typical Low $1,995.26 Median $8,511.38 Typical High $20,417.38 | Facility | None | $1,995.26 | $8,511.38 | $20,417.38 |
United Setting Professional Modifier None Typical Low $1,122.02 Median $1,819.70 Typical High $2,754.23 | Professional | None | $1,122.02 | $1,819.70 | $2,754.23 |
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 $741.31 Median $776.25 Typical High $776.25 | Professional | 52 · Reduced service | $741.31 | $776.25 | $776.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $295.12 Median $309.03 Typical High $316.23 | Professional | 53 · Discontinued | $295.12 | $309.03 | $316.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,096.48 Median $1,174.90 Typical High $1,174.90 | Professional | 54 · Surgery only | $1,096.48 | $1,174.90 | $1,174.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $218.78 Median $234.42 Typical High $234.42 | Professional | 55 · Aftercare only | $218.78 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $147.91 Median $154.88 Typical High $154.88 | Professional | 56 · Pre-op care only | $147.91 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,023.29 Median $1,096.48 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $1,023.29 | $1,096.48 | $1,096.48 |
Where Virginia sits
The same service costs 3.0 times more in Alaska than in Vermont. 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
AK $12,999VT $4,294
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.