How much rates vary
Facilitymedian $617 · 10th to 90th $155 to $3,981Professionalmedian $295 · 10th to 90th $229 to $427
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 $288.40 Median $4,073.80 Typical High $10,000.00 | Facility | None | $288.40 | $4,073.80 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $281.84 Median $295.12 Typical High $457.09 | Professional | None | $281.84 | $295.12 | $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 $257.04 Median $302.00 Typical High $363.08 | Professional | None | $257.04 | $302.00 | $363.08 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $380.19 Median $457.09 Typical High $549.54 | Professional | 50 · Both sides | $380.19 | $457.09 | $549.54 |
CareFirst Setting Professional Modifier None Typical Low $288.40 Median $323.59 Typical High $380.19 | Professional | None | $288.40 | $323.59 | $380.19 |
Cigna Setting Facility Modifier None Typical Low $138.04 Median $316.23 Typical High $1,621.81 | Facility | None | $138.04 | $316.23 | $1,621.81 |
Cigna Setting Professional Modifier None Typical Low $245.47 Median $288.40 Typical High $426.58 | Professional | None | $245.47 | $288.40 | $426.58 |
Kaiser Permanente Setting Professional Modifier None Typical Low $302.00 Median $363.08 Typical High $457.09 | Professional | None | $302.00 | $363.08 | $457.09 |
Medcost Setting Professional Modifier None Typical Low $316.23 Median $389.05 Typical High $446.68 | Professional | None | $316.23 | $389.05 | $446.68 |
Medcost Setting Facility Modifier None Typical Low $288.40 Median $302.00 Typical High $489.78 | Facility | None | $288.40 | $302.00 | $489.78 |
Medcost Setting Professional Modifier None Typical Low $251.19 Median $295.12 Typical High $309.03 | Professional | None | $251.19 | $295.12 | $309.03 |
Sentara Setting Facility Modifier None Typical Low $234.42 Median $446.68 Typical High $2,454.71 | Facility | None | $234.42 | $446.68 | $2,454.71 |
Sentara Setting Professional Modifier None Typical Low $269.15 Median $323.59 Typical High $645.65 | Professional | None | $269.15 | $323.59 | $645.65 |
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 $177.83 Median $245.47 Typical High $478.63 | Professional | None | $177.83 | $245.47 | $478.63 |
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 $141.25 Median $144.54 Typical High $147.91 | Professional | 52 · Reduced service | $141.25 | $144.54 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $57.54 Median $57.54 Typical High $60.26 | Professional | 53 · Discontinued | $57.54 | $57.54 | $60.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $213.80 Median $213.80 Typical High $223.87 | Professional | 54 · Surgery only | $213.80 | $213.80 | $223.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $42.66 Typical High $44.67 | Professional | 55 · Aftercare only | $42.66 | $42.66 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $28.84 Typical High $30.20 | Professional | 56 · Pre-op care only | $28.18 | $28.84 | $30.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $199.53 Median $199.53 Typical High $208.93 | Professional | 78 · Unplanned return to OR | $199.53 | $199.53 | $208.93 |
Where Virginia sits
The same service costs 5.9 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· 34th of 51
$295
AK $1,096TX $186
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.