How much rates vary
Facilitymedian $692 · 10th to 90th $170 to $3,802Professionalmedian $407 · 10th to 90th $316 to $589
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 $416.87 Median $3,801.89 Typical High $9,332.54 | Facility | None | $416.87 | $3,801.89 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $380.19 Median $416.87 Typical High $630.96 | Professional | None | $380.19 | $416.87 | $630.96 |
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 $346.74 Median $407.38 Typical High $489.78 | Professional | None | $346.74 | $407.38 | $489.78 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $512.86 Median $616.60 Typical High $741.31 | Professional | 50 · Both sides | $512.86 | $616.60 | $741.31 |
CareFirst Setting Professional Modifier None Typical Low $371.54 Median $407.38 Typical High $478.63 | Professional | None | $371.54 | $407.38 | $478.63 |
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 $346.74 Median $398.11 Typical High $602.56 | Professional | None | $346.74 | $398.11 | $602.56 |
Kaiser Permanente Setting Professional Modifier None Typical Low $426.58 Median $501.19 Typical High $645.65 | Professional | None | $426.58 | $501.19 | $645.65 |
Medcost Setting Professional Modifier None Typical Low $457.09 Median $562.34 Typical High $562.34 | Professional | None | $457.09 | $562.34 | $562.34 |
Medcost Setting Facility Modifier None Typical Low $389.05 Median $426.58 Typical High $691.83 | Facility | None | $389.05 | $426.58 | $691.83 |
Medcost Setting Professional Modifier None Typical Low $263.03 Median $316.23 Typical High $436.52 | Professional | None | $263.03 | $316.23 | $436.52 |
Sentara Setting Facility Modifier None Typical Low $302.00 Median $501.19 Typical High $2,454.71 | Facility | None | $302.00 | $501.19 | $2,454.71 |
Sentara Setting Professional Modifier None Typical Low $380.19 Median $436.52 Typical High $912.01 | Professional | None | $380.19 | $436.52 | $912.01 |
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 $346.74 Typical High $676.08 | Professional | None | $251.19 | $346.74 | $676.08 |
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 $190.55 Median $194.98 Typical High $213.80 | Professional | 52 · Reduced service | $190.55 | $194.98 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $79.43 Typical High $85.11 | Professional | 53 · Discontinued | $75.86 | $79.43 | $85.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $288.40 Median $295.12 Typical High $316.23 | Professional | 54 · Surgery only | $288.40 | $295.12 | $316.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $58.88 Typical High $63.10 | Professional | 55 · Aftercare only | $57.54 | $58.88 | $63.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $38.90 Typical High $42.66 | Professional | 56 · Pre-op care only | $38.02 | $38.90 | $42.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $269.15 Median $275.42 Typical High $295.12 | Professional | 78 · Unplanned return to OR | $269.15 | $275.42 | $295.12 |
Where Virginia sits
The same service costs 5.1 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
$407
AK $1,479UT $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.