How much rates vary
Facilitymedian $1,585 · 10th to 90th $363 to $6,457Professionalmedian $457 · 10th to 90th $363 to $631
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 $457.09 Median $4,073.80 Typical High $10,000.00 | Facility | None | $457.09 | $4,073.80 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $436.52 Median $457.09 Typical High $630.96 | Professional | None | $436.52 | $457.09 | $630.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,677.35 Median $6,456.54 Typical High $7,244.36 | Facility | None | $4,677.35 | $6,456.54 | $7,244.36 |
Anthem BCBS Setting Professional Modifier None Typical Low $398.11 Median $467.74 Typical High $562.34 | Professional | None | $398.11 | $467.74 | $562.34 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $588.84 Median $707.95 Typical High $851.14 | Professional | 50 · Both sides | $588.84 | $707.95 | $851.14 |
CareFirst Setting Professional Modifier None Typical Low $426.58 Median $467.74 Typical High $616.60 | Professional | None | $426.58 | $467.74 | $616.60 |
Cigna Setting Facility Modifier None Typical Low $346.74 Median $1,621.81 Typical High $3,090.30 | Facility | None | $346.74 | $1,621.81 | $3,090.30 |
Cigna Setting Professional Modifier None Typical Low $371.54 Median $426.58 Typical High $645.65 | Professional | None | $371.54 | $426.58 | $645.65 |
Kaiser Permanente Setting Professional Modifier None Typical Low $389.05 Median $467.74 Typical High $588.84 | Professional | None | $389.05 | $467.74 | $588.84 |
Medcost Setting Professional Modifier None Typical Low $489.78 Median $616.60 Typical High $616.60 | Professional | None | $489.78 | $616.60 | $616.60 |
Medcost Setting Facility Modifier None Typical Low $457.09 Median $489.78 Typical High $741.31 | Facility | None | $457.09 | $489.78 | $741.31 |
Medcost Setting Professional Modifier None Typical Low $354.81 Median $416.87 Typical High $467.74 | Professional | None | $354.81 | $416.87 | $467.74 |
Sentara Setting Facility Modifier None Typical Low $346.74 Median $758.58 Typical High $2,951.21 | Facility | None | $346.74 | $758.58 | $2,951.21 |
Sentara Setting Professional Modifier None Typical Low $363.08 Median $467.74 Typical High $977.24 | Professional | None | $363.08 | $467.74 | $977.24 |
United Setting Facility Modifier None Typical Low $323.59 Median $1,445.44 Typical High $3,981.07 | Facility | None | $323.59 | $1,445.44 | $3,981.07 |
United Setting Professional Modifier None Typical Low $275.42 Median $363.08 Typical High $724.44 | Professional | None | $275.42 | $363.08 | $724.44 |
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 $218.78 Median $223.87 Typical High $223.87 | Professional | 52 · Reduced service | $218.78 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $87.10 Median $91.20 Typical High $91.20 | Professional | 53 · Discontinued | $87.10 | $91.20 | $91.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $338.84 Typical High $338.84 | Professional | 54 · Surgery only | $331.13 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $67.61 Typical High $67.61 | Professional | 55 · Aftercare only | $66.07 | $67.61 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $45.71 Typical High $45.71 | Professional | 56 · Pre-op care only | $43.65 | $45.71 | $45.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $309.03 Median $316.23 Typical High $316.23 | Professional | 78 · Unplanned return to OR | $309.03 | $316.23 | $316.23 |
Where Virginia sits
The same service costs 8.1 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· 35th of 51
$457
AK $1,698TX $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.