How much rates vary
Facilitymedian $589 · 10th to 90th $138 to $4,074Professionalmedian $302 · 10th to 90th $229 to $447
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 $281.84 Median $4,073.80 Typical High $10,000.00 | Facility | None | $281.84 | $4,073.80 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $281.84 Median $316.23 Typical High $501.19 | Professional | None | $281.84 | $316.23 | $501.19 |
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 $50.12 Median $141.25 Typical High $263.03 | Facility | None | $50.12 | $141.25 | $263.03 |
Cigna Setting Professional Modifier None Typical Low $251.19 Median $302.00 Typical High $446.68 | Professional | None | $251.19 | $302.00 | $446.68 |
Kaiser Permanente Setting Professional Modifier None Typical Low $323.59 Median $389.05 Typical High $489.78 | Professional | None | $323.59 | $389.05 | $489.78 |
Medcost Setting Professional Modifier None Typical Low $316.23 Median $398.11 Typical High $398.11 | Professional | None | $316.23 | $398.11 | $398.11 |
Medcost Setting Facility Modifier None Typical Low $281.84 Median $316.23 Typical High $512.86 | Facility | None | $281.84 | $316.23 | $512.86 |
Medcost Setting Professional Modifier None Typical Low $269.15 Median $281.84 Typical High $309.03 | Professional | None | $269.15 | $281.84 | $309.03 |
Sentara Setting Facility Modifier None Typical Low $229.09 Median $436.52 Typical High $2,454.71 | Facility | None | $229.09 | $436.52 | $2,454.71 |
Sentara Setting Professional Modifier None Typical Low $251.19 Median $316.23 Typical High $691.83 | Professional | None | $251.19 | $316.23 | $691.83 |
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 $181.97 Median $257.04 Typical High $501.19 | Professional | None | $181.97 | $257.04 | $501.19 |
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 $147.91 Typical High $158.49 | Professional | 52 · Reduced service | $141.25 | $147.91 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $60.26 Typical High $64.57 | Professional | 53 · Discontinued | $56.23 | $60.26 | $64.57 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $213.80 Median $223.87 Typical High $239.88 | Professional | 54 · Surgery only | $213.80 | $223.87 | $239.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $44.67 Typical High $47.86 | Professional | 55 · Aftercare only | $42.66 | $44.67 | $47.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $30.20 Typical High $31.62 | Professional | 56 · Pre-op care only | $28.18 | $30.20 | $31.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $199.53 Median $208.93 Typical High $223.87 | Professional | 78 · Unplanned return to OR | $199.53 | $208.93 | $223.87 |
Where Virginia sits
The same service costs 5.4 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· 35th of 51
$302
AK $1,096TX $204
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.