How much rates vary
Facilitymedian $603 · 10th to 90th $141 to $4,074Professionalmedian $363 · 10th to 90th $269 to $537
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 $371.54 Median $3,981.07 Typical High $9,332.54 | Facility | None | $371.54 | $3,981.07 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $346.74 Median $371.54 Typical High $588.84 | Professional | None | $346.74 | $371.54 | $588.84 |
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 $316.23 Median $380.19 Typical High $457.09 | Professional | None | $316.23 | $380.19 | $457.09 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $478.63 Median $575.44 Typical High $691.83 | Professional | 50 · Both sides | $478.63 | $575.44 | $691.83 |
CareFirst Setting Professional Modifier None Typical Low $363.08 Median $407.38 Typical High $478.63 | Professional | None | $363.08 | $407.38 | $478.63 |
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 $295.12 Median $346.74 Typical High $537.03 | Professional | None | $295.12 | $346.74 | $537.03 |
Kaiser Permanente Setting Professional Modifier None Typical Low $371.54 Median $446.68 Typical High $575.44 | Professional | None | $371.54 | $446.68 | $575.44 |
Medcost Setting Professional Modifier None Typical Low $346.74 Median $436.52 Typical High $436.52 | Professional | None | $346.74 | $436.52 | $436.52 |
Medcost Setting Facility Modifier None Typical Low $316.23 Median $346.74 Typical High $602.56 | Facility | None | $316.23 | $346.74 | $602.56 |
Medcost Setting Professional Modifier None Typical Low $275.42 Median $281.84 Typical High $331.13 | Professional | None | $275.42 | $281.84 | $331.13 |
Sentara Setting Facility Modifier None Typical Low $269.15 Median $478.63 Typical High $2,454.71 | Facility | None | $269.15 | $478.63 | $2,454.71 |
Sentara Setting Professional Modifier None Typical Low $269.15 Median $354.81 Typical High $812.83 | Professional | None | $269.15 | $354.81 | $812.83 |
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 $208.93 Median $302.00 Typical High $588.84 | Professional | None | $208.93 | $302.00 | $588.84 |
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 $173.78 Median $177.83 Typical High $186.21 | Professional | 52 · Reduced service | $173.78 | $177.83 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $70.79 Typical High $74.13 | Professional | 53 · Discontinued | $69.18 | $70.79 | $74.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $269.15 Typical High $281.84 | Professional | 54 · Surgery only | $263.03 | $269.15 | $281.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $53.70 Typical High $56.23 | Professional | 55 · Aftercare only | $52.48 | $53.70 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $35.48 Typical High $37.15 | Professional | 56 · Pre-op care only | $34.67 | $35.48 | $37.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $245.47 Median $251.19 Typical High $263.03 | Professional | 78 · Unplanned return to OR | $245.47 | $251.19 | $263.03 |
Where Virginia sits
The same service costs 5.6 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
$363
AK $1,380TX $245
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.