How much rates vary
Facilitymedian $3,802 · 10th to 90th $417 to $13,183Professionalmedian $389 · 10th to 90th $302 to $603
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 $363.08 Median $5,248.07 Typical High $10,000.00 | Facility | None | $363.08 | $5,248.07 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $346.74 Median $467.74 Typical High $478.63 | Professional | None | $346.74 | $467.74 | $478.63 |
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 $309.03 Median $371.54 Typical High $446.68 | Professional | None | $309.03 | $371.54 | $446.68 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $467.74 Median $562.34 Typical High $676.08 | Professional | 50 · Both sides | $467.74 | $562.34 | $676.08 |
CareFirst Setting Professional Modifier None Typical Low $323.59 Median $354.81 Typical High $467.74 | Professional | None | $323.59 | $354.81 | $467.74 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $1,513.56 Typical High $2,818.38 | Facility | None | $524.81 | $1,513.56 | $2,818.38 |
Cigna Setting Professional Modifier None Typical Low $323.59 Median $436.52 Typical High $645.65 | Professional | None | $323.59 | $436.52 | $645.65 |
Kaiser Permanente Setting Professional Modifier None Typical Low $436.52 Median $524.81 Typical High $660.69 | Professional | None | $436.52 | $524.81 | $660.69 |
Medcost Setting Professional Modifier None Typical Low $457.09 Median $616.60 Typical High $616.60 | Professional | None | $457.09 | $616.60 | $616.60 |
Medcost Setting Facility Modifier None Typical Low $363.08 Median $478.63 Typical High $776.25 | Facility | None | $363.08 | $478.63 | $776.25 |
Medcost Setting Professional Modifier None Typical Low $295.12 Median $524.81 Typical High $794.33 | Professional | None | $295.12 | $524.81 | $794.33 |
Sentara Setting Facility Modifier None Typical Low $275.42 Median $1,445.44 Typical High $10,232.93 | Facility | None | $275.42 | $1,445.44 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $295.12 Median $512.86 Typical High $1,047.13 | Professional | None | $295.12 | $512.86 | $1,047.13 |
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 $234.42 Median $380.19 Typical High $707.95 | Professional | None | $234.42 | $380.19 | $707.95 |
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 $173.78 Median $213.80 Typical High $239.88 | Professional | 52 · Reduced service | $173.78 | $213.80 | $239.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $85.11 Typical High $95.50 | Professional | 53 · Discontinued | $69.18 | $85.11 | $95.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $323.59 Typical High $363.08 | Professional | 54 · Surgery only | $257.04 | $323.59 | $363.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $64.57 Typical High $72.44 | Professional | 55 · Aftercare only | $51.29 | $64.57 | $72.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $42.66 Typical High $47.86 | Professional | 56 · Pre-op care only | $34.67 | $42.66 | $47.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $239.88 Median $302.00 Typical High $338.84 | Professional | 78 · Unplanned return to OR | $239.88 | $302.00 | $338.84 |
Where Virginia sits
The same service costs 5.0 times more in Alaska than in Utah. 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· 43rd of 51
$389
AK $1,622UT $324
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.