How much rates vary
Facilitymedian $1,820 · 10th to 90th $263 to $5,754Professionalmedian $263 · 10th to 90th $209 to $372
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 $263.03 Median $3,981.07 Typical High $9,332.54 | Facility | None | $263.03 | $3,981.07 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $338.84 | Professional | None | $263.03 | $263.03 | $338.84 |
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 $234.42 Median $281.84 Typical High $338.84 | Professional | None | $234.42 | $281.84 | $338.84 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $354.81 Median $416.87 Typical High $501.19 | Professional | 50 · Both sides | $354.81 | $416.87 | $501.19 |
CareFirst Setting Professional Modifier None Typical Low $257.04 Median $281.84 Typical High $371.54 | Professional | None | $257.04 | $281.84 | $371.54 |
Cigna Setting Facility Modifier None Typical Low $346.74 Median $891.25 Typical High $1,698.24 | Facility | None | $346.74 | $891.25 | $1,698.24 |
Cigna Setting Professional Modifier None Typical Low $218.78 Median $257.04 Typical High $380.19 | Professional | None | $218.78 | $257.04 | $380.19 |
Kaiser Permanente Setting Professional Modifier None Typical Low $263.03 Median $316.23 Typical High $398.11 | Professional | None | $263.03 | $316.23 | $398.11 |
Medcost Setting Professional Modifier None Typical Low $263.03 Median $331.13 Typical High $346.74 | Professional | None | $263.03 | $331.13 | $346.74 |
Medcost Setting Facility Modifier None Typical Low $263.03 Median $269.15 Typical High $426.58 | Facility | None | $263.03 | $269.15 | $426.58 |
Medcost Setting Professional Modifier None Typical Low $204.17 Median $218.78 Typical High $263.03 | Professional | None | $204.17 | $218.78 | $263.03 |
Sentara Setting Facility Modifier None Typical Low $208.93 Median $1,023.29 Typical High $3,630.78 | Facility | None | $208.93 | $1,023.29 | $3,630.78 |
Sentara Setting Professional Modifier None Typical Low $208.93 Median $263.03 Typical High $575.44 | Professional | None | $208.93 | $263.03 | $575.44 |
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 $158.49 Median $213.80 Typical High $426.58 | Professional | None | $158.49 | $213.80 | $426.58 |
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 $131.83 Median $131.83 Typical High $131.83 | Professional | 52 · Reduced service | $131.83 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $52.48 Typical High $52.48 | Professional | 53 · Discontinued | $52.48 | $52.48 | $52.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $194.98 Typical High $199.53 | Professional | 54 · Surgery only | $194.98 | $194.98 | $199.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $39.81 Typical High $39.81 | Professional | 55 · Aftercare only | $38.90 | $39.81 | $39.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $26.30 Typical High $26.30 | Professional | 56 · Pre-op care only | $26.30 | $26.30 | $26.30 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $181.97 Median $181.97 Typical High $186.21 | Professional | 78 · Unplanned return to OR | $181.97 | $181.97 | $186.21 |
Where Virginia sits
The same service costs 5.4 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· 36th of 51
$263
AK $1,023UT $191
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.