How much rates vary
Facilitymedian $1,318 · 10th to 90th $234 to $4,786Professionalmedian $209 · 10th to 90th $166 to $363
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 $295.12 Median $3,801.89 Typical High $9,332.54 | Facility | None | $295.12 | $3,801.89 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $181.97 Median $269.15 Typical High $309.03 | Professional | None | $181.97 | $269.15 | $309.03 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,884.03 Median $3,715.35 Typical High $4,265.80 | Facility | None | $2,884.03 | $3,715.35 | $4,265.80 |
Anthem BCBS Setting Professional Modifier None Typical Low $165.96 Median $199.53 Typical High $239.88 | Professional | None | $165.96 | $199.53 | $239.88 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $245.47 Median $295.12 Typical High $354.81 | Professional | 50 · Both sides | $245.47 | $295.12 | $354.81 |
CareFirst Setting Professional Modifier None Typical Low $173.78 Median $194.98 Typical High $257.04 | Professional | None | $173.78 | $194.98 | $257.04 |
Cigna Setting Facility Modifier None Typical Low $346.74 Median $812.83 Typical High $1,659.59 | Facility | None | $346.74 | $812.83 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $173.78 Median $263.03 Typical High $398.11 | Professional | None | $173.78 | $263.03 | $398.11 |
Kaiser Permanente Setting Professional Modifier None Typical Low $269.15 Median $323.59 Typical High $407.38 | Professional | None | $269.15 | $323.59 | $407.38 |
Medcost Setting Professional Modifier None Typical Low $245.47 Median $363.08 Typical High $363.08 | Professional | None | $245.47 | $363.08 | $363.08 |
Medcost Setting Facility Modifier None Typical Low $199.53 Median $309.03 Typical High $501.19 | Facility | None | $199.53 | $309.03 | $501.19 |
Medcost Setting Professional Modifier None Typical Low $141.25 Median $169.82 Typical High $316.23 | Professional | None | $141.25 | $169.82 | $316.23 |
Sentara Setting Facility Modifier None Typical Low $158.49 Median $616.60 Typical High $3,311.31 | Facility | None | $158.49 | $616.60 | $3,311.31 |
Sentara Setting Professional Modifier None Typical Low $234.42 Median $323.59 Typical High $676.08 | Professional | None | $234.42 | $323.59 | $676.08 |
United Setting Facility Modifier None Typical Low $323.59 Median $1,445.44 Typical High $3,630.78 | Facility | None | $323.59 | $1,445.44 | $3,630.78 |
United Setting Professional Modifier None Typical Low $134.90 Median $229.09 Typical High $426.58 | Professional | None | $134.90 | $229.09 | $426.58 |
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 $91.20 Median $128.82 Typical High $154.88 | Professional | 52 · Reduced service | $91.20 | $128.82 | $154.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $51.29 Typical High $61.66 | Professional | 53 · Discontinued | $36.31 | $51.29 | $61.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $194.98 Typical High $234.42 | Professional | 54 · Surgery only | $138.04 | $194.98 | $234.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $38.90 Typical High $46.77 | Professional | 55 · Aftercare only | $27.54 | $38.90 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $25.70 Typical High $30.90 | Professional | 56 · Pre-op care only | $18.20 | $25.70 | $30.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $128.82 Median $181.97 Typical High $218.78 | Professional | 78 · Unplanned return to OR | $128.82 | $181.97 | $218.78 |
Where Virginia sits
The same service costs 4.1 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· 50th of 51
$214
AK $851TX $209
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.