How much rates vary
Facilitymedian $676 · 10th to 90th $162 to $3,981Professionalmedian $355 · 10th to 90th $275 to $525
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 $363.08 Median $3,981.07 Typical High $9,332.54 | Facility | None | $363.08 | $3,981.07 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $331.13 Median $363.08 Typical High $562.34 | Professional | None | $331.13 | $363.08 | $562.34 |
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 $302.00 Median $363.08 Typical High $426.58 | Professional | None | $302.00 | $363.08 | $426.58 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $446.68 Median $537.03 Typical High $645.65 | Professional | 50 · Both sides | $446.68 | $537.03 | $645.65 |
CareFirst Setting Professional Modifier None Typical Low $323.59 Median $363.08 Typical High $426.58 | Professional | None | $323.59 | $363.08 | $426.58 |
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 $302.00 Median $346.74 Typical High $524.81 | Professional | None | $302.00 | $346.74 | $524.81 |
Kaiser Permanente Setting Professional Modifier None Typical Low $363.08 Median $436.52 Typical High $562.34 | Professional | None | $363.08 | $436.52 | $562.34 |
Medcost Setting Professional Modifier None Typical Low $398.11 Median $501.19 Typical High $501.19 | Professional | None | $398.11 | $501.19 | $501.19 |
Medcost Setting Facility Modifier None Typical Low $338.84 Median $371.54 Typical High $602.56 | Facility | None | $338.84 | $371.54 | $602.56 |
Medcost Setting Professional Modifier None Typical Low $295.12 Median $309.03 Typical High $389.05 | Professional | None | $295.12 | $309.03 | $389.05 |
Sentara Setting Facility Modifier None Typical Low $275.42 Median $436.52 Typical High $2,454.71 | Facility | None | $275.42 | $436.52 | $2,454.71 |
Sentara Setting Professional Modifier None Typical Low $323.59 Median $398.11 Typical High $812.83 | Professional | None | $323.59 | $398.11 | $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 $218.78 Median $302.00 Typical High $588.84 | Professional | None | $218.78 | $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 $165.96 Median $169.82 Typical High $186.21 | Professional | 52 · Reduced service | $165.96 | $169.82 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $67.61 Typical High $74.13 | Professional | 53 · Discontinued | $66.07 | $67.61 | $74.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $257.04 Typical High $281.84 | Professional | 54 · Surgery only | $251.19 | $257.04 | $281.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $51.29 Typical High $56.23 | Professional | 55 · Aftercare only | $50.12 | $51.29 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $33.88 Typical High $37.15 | Professional | 56 · Pre-op care only | $33.11 | $33.88 | $37.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $234.42 Median $239.88 Typical High $263.03 | Professional | 78 · Unplanned return to OR | $234.42 | $239.88 | $263.03 |
Where Virginia sits
The same service costs 5.9 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
$363
AK $1,288UT $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.