How much rates vary
Facilitymedian $692 · 10th to 90th $162 to $3,981Professionalmedian $407 · 10th to 90th $316 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 $436.52 Median $3,981.07 Typical High $9,332.54 | Facility | None | $436.52 | $3,981.07 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $398.11 Median $436.52 Typical High $457.09 | Professional | None | $398.11 | $436.52 | $457.09 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,698.24 Median $2,398.83 Typical High $2,951.21 | Facility | None | $1,698.24 | $2,398.83 | $2,951.21 |
Anthem BCBS Setting Professional Modifier None Typical Low $354.81 Median $426.58 Typical High $512.86 | Professional | None | $354.81 | $426.58 | $512.86 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $524.81 Median $630.96 Typical High $758.58 | Professional | 50 · Both sides | $524.81 | $630.96 | $758.58 |
CareFirst Setting Professional Modifier None Typical Low $380.19 Median $426.58 Typical High $501.19 | Professional | None | $380.19 | $426.58 | $501.19 |
Cigna Setting Facility Modifier None Typical Low $138.04 Median $323.59 Typical High $1,621.81 | Facility | None | $138.04 | $323.59 | $1,621.81 |
Cigna Setting Professional Modifier None Typical Low $338.84 Median $407.38 Typical High $616.60 | Professional | None | $338.84 | $407.38 | $616.60 |
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 $416.87 Median $524.81 Typical High $524.81 | Professional | None | $416.87 | $524.81 | $524.81 |
Medcost Setting Facility Modifier None Typical Low $398.11 Median $416.87 Typical High $707.95 | Facility | None | $398.11 | $416.87 | $707.95 |
Medcost Setting Professional Modifier None Typical Low $316.23 Median $331.13 Typical High $416.87 | Professional | None | $316.23 | $331.13 | $416.87 |
Sentara Setting Facility Modifier None Typical Low $309.03 Median $478.63 Typical High $2,454.71 | Facility | None | $309.03 | $478.63 | $2,454.71 |
Sentara Setting Professional Modifier None Typical Low $338.84 Median $436.52 Typical High $933.25 | Professional | None | $338.84 | $436.52 | $933.25 |
United Setting Facility Modifier None Typical Low $100.00 Median $660.69 Typical High $2,041.74 | Facility | None | $100.00 | $660.69 | $2,041.74 |
United Setting Professional Modifier None Typical Low $251.19 Median $354.81 Typical High $691.83 | Professional | None | $251.19 | $354.81 | $691.83 |
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 $199.53 Median $204.17 Typical High $218.78 | Professional | 52 · Reduced service | $199.53 | $204.17 | $218.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $81.28 Typical High $87.10 | Professional | 53 · Discontinued | $79.43 | $81.28 | $87.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $295.12 Median $302.00 Typical High $323.59 | Professional | 54 · Surgery only | $295.12 | $302.00 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $60.26 Typical High $64.57 | Professional | 55 · Aftercare only | $58.88 | $60.26 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $40.74 Typical High $43.65 | Professional | 56 · Pre-op care only | $39.81 | $40.74 | $43.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $275.42 Median $281.84 Typical High $302.00 | Professional | 78 · Unplanned return to OR | $275.42 | $281.84 | $302.00 |
Where Virginia sits
The same service costs 5.2 times more in Alaska than in Texas. 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
$417
AK $1,514TX $288
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.