How much rates vary
Facilitymedian $1,738 · 10th to 90th $93 to $5,754Professionalmedian $138 · 10th to 90th $68 to $224
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 $158.49 Median $3,981.07 Typical High $9,332.54 | Facility | None | $158.49 | $3,981.07 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $67.61 Median $154.88 Typical High $295.12 | Professional | None | $67.61 | $154.88 | $295.12 |
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 $67.61 Median $125.89 Typical High $194.98 | Professional | None | $67.61 | $125.89 | $194.98 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $102.33 Median $177.83 Typical High $288.40 | Professional | 50 · Both sides | $102.33 | $177.83 | $288.40 |
CareFirst Setting Professional Modifier None Typical Low $75.86 Median $83.18 Typical High $1,659.59 | Professional | None | $75.86 | $83.18 | $1,659.59 |
Cigna Setting Facility Modifier None Typical Low $346.74 Median $812.83 Typical High $1,659.59 | Facility | None | $346.74 | $812.83 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $67.61 Median $138.04 Typical High $223.87 | Professional | None | $67.61 | $138.04 | $223.87 |
Kaiser Permanente Setting Professional Modifier None Typical Low $58.88 Median $190.55 Typical High $234.42 | Professional | None | $58.88 | $190.55 | $234.42 |
Medcost Setting Professional Modifier None Typical Low $169.82 Median $213.80 Typical High $213.80 | Professional | None | $169.82 | $213.80 | $213.80 |
Medcost Setting Facility Modifier None Typical Low $79.43 Median $128.82 Typical High $275.42 | Facility | None | $79.43 | $128.82 | $275.42 |
Medcost Setting Professional Modifier None Typical Low $169.82 Median $169.82 Typical High $169.82 | Professional | None | $169.82 | $169.82 | $169.82 |
Sentara Setting Facility Modifier None Typical Low $66.07 Median $870.96 Typical High $3,630.78 | Facility | None | $66.07 | $870.96 | $3,630.78 |
Sentara Setting Professional Modifier None Typical Low $131.83 Median $194.98 Typical High $1,949.84 | Professional | None | $131.83 | $194.98 | $1,949.84 |
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 $61.66 Median $125.89 Typical High $269.15 | Professional | None | $61.66 | $125.89 | $269.15 |
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 $33.88 Median $50.12 Typical High $85.11 | Professional | 52 · Reduced service | $33.88 | $50.12 | $85.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $19.95 Typical High $33.88 | Professional | 53 · Discontinued | $13.80 | $19.95 | $33.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $51.29 Median $75.86 Typical High $125.89 | Professional | 54 · Surgery only | $51.29 | $75.86 | $125.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $15.14 Typical High $25.12 | Professional | 55 · Aftercare only | $10.23 | $15.14 | $25.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $10.00 Typical High $16.98 | Professional | 56 · Pre-op care only | $6.92 | $10.00 | $16.98 |
Where Virginia sits
The same service costs 4.9 times more in Alaska than in Hawaii. 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
$145
AK $437HI $89.13
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.