How much rates vary
Facilitymedian $676 · 10th to 90th $162 to $3,981Professionalmedian $347 · 10th to 90th $269 to $501
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 $354.81 Median $3,981.07 Typical High $9,332.54 | Facility | None | $354.81 | $3,981.07 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $331.13 Median $354.81 Typical High $501.19 | Professional | None | $331.13 | $354.81 | $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 $295.12 Median $354.81 Typical High $426.58 | Professional | None | $295.12 | $354.81 | $426.58 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $436.52 Median $524.81 Typical High $630.96 | Professional | 50 · Both sides | $436.52 | $524.81 | $630.96 |
CareFirst Setting Professional Modifier None Typical Low $316.23 Median $354.81 Typical High $416.87 | Professional | None | $316.23 | $354.81 | $416.87 |
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 $288.40 Median $338.84 Typical High $512.86 | Professional | None | $288.40 | $338.84 | $512.86 |
Kaiser Permanente Setting Professional Modifier None Typical Low $363.08 Median $436.52 Typical High $549.54 | Professional | None | $363.08 | $436.52 | $549.54 |
Medcost Setting Professional Modifier None Typical Low $380.19 Median $478.63 Typical High $478.63 | Professional | None | $380.19 | $478.63 | $478.63 |
Medcost Setting Facility Modifier None Typical Low $331.13 Median $363.08 Typical High $588.84 | Facility | None | $331.13 | $363.08 | $588.84 |
Medcost Setting Professional Modifier None Typical Low $269.15 Median $316.23 Typical High $371.54 | Professional | None | $269.15 | $316.23 | $371.54 |
Sentara Setting Facility Modifier None Typical Low $269.15 Median $436.52 Typical High $2,454.71 | Facility | None | $269.15 | $436.52 | $2,454.71 |
Sentara Setting Professional Modifier None Typical Low $316.23 Median $380.19 Typical High $776.25 | Professional | None | $316.23 | $380.19 | $776.25 |
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 $213.80 Median $295.12 Typical High $562.34 | Professional | None | $213.80 | $295.12 | $562.34 |
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 $165.96 Median $165.96 Typical High $181.97 | Professional | 52 · Reduced service | $165.96 | $165.96 | $181.97 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $67.61 Typical High $72.44 | Professional | 53 · Discontinued | $66.07 | $67.61 | $72.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $251.19 Typical High $269.15 | Professional | 54 · Surgery only | $245.47 | $251.19 | $269.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $50.12 Typical High $53.70 | Professional | 55 · Aftercare only | $48.98 | $50.12 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $33.11 Typical High $36.31 | Professional | 56 · Pre-op care only | $33.11 | $33.11 | $36.31 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $234.42 Typical High $251.19 | Professional | 78 · Unplanned return to OR | $229.09 | $234.42 | $251.19 |
Where Virginia sits
The same service costs 5.8 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· 35th of 51
$355
AK $1,259UT $219
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.