How much rates vary
Facilitymedian $4,677 · 10th to 90th $1,445 to $11,220Professionalmedian $2,188 · 10th to 90th $1,698 to $3,467
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 $2,691.53 Median $5,370.32 Typical High $14,125.38 | Facility | None | $2,691.53 | $5,370.32 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $2,187.76 Median $2,454.71 Typical High $3,801.89 | Professional | None | $2,187.76 | $2,454.71 | $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 $1,659.59 Median $1,995.26 Typical High $2,398.83 | Professional | None | $1,659.59 | $1,995.26 | $2,398.83 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $2,454.71 Median $2,951.21 Typical High $3,548.13 | Professional | 50 · Both sides | $2,454.71 | $2,951.21 | $3,548.13 |
CareFirst Setting Professional Modifier None Typical Low $2,884.03 Median $3,235.94 Typical High $3,801.89 | Professional | None | $2,884.03 | $3,235.94 | $3,801.89 |
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 $2,187.76 Median $2,398.83 Typical High $3,548.13 | Professional | None | $2,187.76 | $2,398.83 | $3,548.13 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,137.96 Median $2,630.27 Typical High $3,162.28 | Professional | None | $2,137.96 | $2,630.27 | $3,162.28 |
Medcost Setting Facility Modifier None Typical Low $2,691.53 Median $3,019.95 Typical High $4,073.80 | Facility | None | $2,691.53 | $3,019.95 | $4,073.80 |
Medcost Setting Professional Modifier None Typical Low $4,265.80 Median $4,265.80 Typical High $4,265.80 | Professional | None | $4,265.80 | $4,265.80 | $4,265.80 |
Sentara Setting Facility Modifier None Typical Low $1,659.59 Median $2,884.03 Typical High $10,232.93 | Facility | None | $1,659.59 | $2,884.03 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $1,698.24 Median $2,818.38 Typical High $8,912.51 | Professional | None | $1,698.24 | $2,818.38 | $8,912.51 |
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 $1,778.28 Median $2,454.71 Typical High $4,365.16 | Professional | None | $1,778.28 | $2,454.71 | $4,365.16 |
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 $1,096.48 Median $1,202.26 Typical High $1,348.96 | Professional | 52 · Reduced service | $1,096.48 | $1,202.26 | $1,348.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $436.52 Median $489.78 Typical High $537.03 | Professional | 53 · Discontinued | $436.52 | $489.78 | $537.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,659.59 Median $1,819.70 Typical High $2,041.74 | Professional | 54 · Surgery only | $1,659.59 | $1,819.70 | $2,041.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $331.13 Median $363.08 Typical High $407.38 | Professional | 55 · Aftercare only | $331.13 | $363.08 | $407.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $218.78 Median $245.47 Typical High $269.15 | Professional | 56 · Pre-op care only | $218.78 | $245.47 | $269.15 |
Where Virginia sits
The same service costs 7.1 times more in Alaska than in Kentucky. 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· 39th of 51
$2,291
AK $9,772KY $1,380
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.