How much rates vary
Facilitymedian $4,365 · 10th to 90th $1,072 to $10,965Professionalmedian $1,202 · 10th to 90th $933 to $1,862
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 $1,445.44 Median $5,370.32 Typical High $14,125.38 | Facility | None | $1,445.44 | $5,370.32 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $1,174.90 Median $1,288.25 Typical High $3,801.89 | Professional | None | $1,174.90 | $1,288.25 | $3,801.89 |
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 $912.01 Median $1,096.48 Typical High $1,318.26 | Professional | None | $912.01 | $1,096.48 | $1,318.26 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,380.38 Median $1,621.81 Typical High $1,995.26 | Professional | 50 · Both sides | $1,380.38 | $1,621.81 | $1,995.26 |
CareFirst Setting Professional Modifier None Typical Low $1,258.93 Median $1,380.38 Typical High $1,659.59 | Professional | None | $1,258.93 | $1,380.38 | $1,659.59 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $1,995.26 Typical High $3,715.35 | Facility | None | $524.81 | $1,995.26 | $3,715.35 |
Cigna Setting Professional Modifier None Typical Low $1,071.52 Median $1,258.93 Typical High $1,905.46 | Professional | None | $1,071.52 | $1,258.93 | $1,905.46 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,148.15 Median $1,380.38 Typical High $1,659.59 | Professional | None | $1,148.15 | $1,380.38 | $1,659.59 |
Medcost Setting Facility Modifier None Typical Low $1,445.44 Median $1,584.89 Typical High $2,187.76 | Facility | None | $1,445.44 | $1,584.89 | $2,187.76 |
Medcost Setting Professional Modifier None Typical Low $3,019.95 Median $3,019.95 Typical High $3,019.95 | Professional | None | $3,019.95 | $3,019.95 | $3,019.95 |
Sentara Setting Facility Modifier None Typical Low $794.33 Median $2,398.83 Typical High $10,232.93 | Facility | None | $794.33 | $2,398.83 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $741.31 Median $1,513.56 Typical High $6,606.93 | Professional | None | $741.31 | $1,513.56 | $6,606.93 |
United Setting Facility Modifier None Typical Low $1,548.82 Median $6,760.83 Typical High $16,595.87 | Facility | None | $1,548.82 | $6,760.83 | $16,595.87 |
United Setting Professional Modifier None Typical Low $933.25 Median $1,258.93 Typical High $2,290.87 | Professional | None | $933.25 | $1,258.93 | $2,290.87 |
5 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 $575.44 Median $645.65 Typical High $707.95 | Professional | 52 · Reduced service | $575.44 | $645.65 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $257.04 Typical High $288.40 | Professional | 53 · Discontinued | $234.42 | $257.04 | $288.40 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $954.99 Typical High $1,071.52 | Professional | 54 · Surgery only | $870.96 | $954.99 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $194.98 Typical High $213.80 | Professional | 55 · Aftercare only | $173.78 | $194.98 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $128.82 Typical High $144.54 | Professional | 56 · Pre-op care only | $114.82 | $128.82 | $144.54 |
Where Virginia sits
The same service costs 4.8 times more in Alaska than in New York. 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.
Virginia· 46th of 51
$1,230
AK $5,129NY $1,072
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.