How much rates vary
Facilitymedian $776 · 10th to 90th $162 to $3,981Professionalmedian $537 · 10th to 90th $427 to $794
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 $562.34 Median $3,981.07 Typical High $9,332.54 | Facility | None | $562.34 | $3,981.07 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $524.81 Median $562.34 Typical High $575.44 | Professional | None | $524.81 | $562.34 | $575.44 |
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 $467.74 Median $562.34 Typical High $676.08 | Professional | None | $467.74 | $562.34 | $676.08 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $707.95 Median $831.76 Typical High $1,000.00 | Professional | 50 · Both sides | $707.95 | $831.76 | $1,000.00 |
CareFirst Setting Professional Modifier None Typical Low $501.19 Median $562.34 Typical High $660.69 | Professional | None | $501.19 | $562.34 | $660.69 |
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 $457.09 Median $537.03 Typical High $794.33 | Professional | None | $457.09 | $537.03 | $794.33 |
Kaiser Permanente Setting Professional Modifier None Typical Low $549.54 Median $660.69 Typical High $851.14 | Professional | None | $549.54 | $660.69 | $851.14 |
Medcost Setting Professional Modifier None Typical Low $616.60 Median $776.25 Typical High $776.25 | Professional | None | $616.60 | $776.25 | $776.25 |
Medcost Setting Facility Modifier None Typical Low $537.03 Median $588.84 Typical High $933.25 | Facility | None | $537.03 | $588.84 | $933.25 |
Medcost Setting Professional Modifier None Typical Low $588.84 Median $616.60 Typical High $707.95 | Professional | None | $588.84 | $616.60 | $707.95 |
Sentara Setting Facility Modifier None Typical Low $371.54 Median $616.60 Typical High $2,454.71 | Facility | None | $371.54 | $616.60 | $2,454.71 |
Sentara Setting Professional Modifier None Typical Low $512.86 Median $602.56 Typical High $1,230.27 | Professional | None | $512.86 | $602.56 | $1,230.27 |
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 $338.84 Median $467.74 Typical High $912.01 | Professional | None | $338.84 | $467.74 | $912.01 |
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 $263.03 Median $269.15 Typical High $288.40 | Professional | 52 · Reduced service | $263.03 | $269.15 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $107.15 Typical High $114.82 | Professional | 53 · Discontinued | $104.71 | $107.15 | $114.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $398.11 Typical High $426.58 | Professional | 54 · Surgery only | $389.05 | $398.11 | $426.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $81.28 Typical High $85.11 | Professional | 55 · Aftercare only | $77.62 | $81.28 | $85.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $53.70 Typical High $57.54 | Professional | 56 · Pre-op care only | $52.48 | $53.70 | $57.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $371.54 Typical High $398.11 | Professional | 78 · Unplanned return to OR | $363.08 | $371.54 | $398.11 |
Where Virginia sits
The same service costs 5.8 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
$550
AK $2,042TX $355
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.