How much rates vary
Facilitymedian $3,090 · 10th to 90th $309 to $9,550Professionalmedian $282 · 10th to 90th $219 to $513
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 $389.05 Median $4,073.80 Typical High $9,332.54 | Facility | None | $389.05 | $4,073.80 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $239.88 Median $389.05 Typical High $426.58 | Professional | None | $239.88 | $389.05 | $426.58 |
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 $218.78 Median $263.03 Typical High $316.23 | Professional | None | $218.78 | $263.03 | $316.23 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $331.13 Median $398.11 Typical High $478.63 | Professional | 50 · Both sides | $331.13 | $398.11 | $478.63 |
CareFirst Setting Professional Modifier None Typical Low $234.42 Median $257.04 Typical High $338.84 | Professional | None | $234.42 | $257.04 | $338.84 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $1,659.59 Typical High $3,090.30 | Facility | None | $478.63 | $1,659.59 | $3,090.30 |
Cigna Setting Professional Modifier None Typical Low $234.42 Median $354.81 Typical High $524.81 | Professional | None | $234.42 | $354.81 | $524.81 |
Kaiser Permanente Setting Professional Modifier None Typical Low $354.81 Median $416.87 Typical High $524.81 | Professional | None | $354.81 | $416.87 | $524.81 |
Medcost Setting Professional Modifier None Typical Low $416.87 Median $524.81 Typical High $549.54 | Professional | None | $416.87 | $524.81 | $549.54 |
Medcost Setting Facility Modifier None Typical Low $263.03 Median $426.58 Typical High $691.83 | Facility | None | $263.03 | $426.58 | $691.83 |
Medcost Setting Professional Modifier None Typical Low $323.59 Median $354.81 Typical High $457.09 | Professional | None | $323.59 | $354.81 | $457.09 |
Sentara Setting Facility Modifier None Typical Low $245.47 Median $1,071.52 Typical High $8,709.64 | Facility | None | $245.47 | $1,071.52 | $8,709.64 |
Sentara Setting Professional Modifier None Typical Low $346.74 Median $446.68 Typical High $912.01 | Professional | None | $346.74 | $446.68 | $912.01 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $5,011.87 Typical High $13,182.57 | Facility | None | $1,230.27 | $5,011.87 | $13,182.57 |
United Setting Professional Modifier None Typical Low $181.97 Median $323.59 Typical High $588.84 | Professional | None | $181.97 | $323.59 | $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 $120.23 Median $173.78 Typical High $213.80 | Professional | 52 · Reduced service | $120.23 | $173.78 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $69.18 Typical High $85.11 | Professional | 53 · Discontinued | $47.86 | $69.18 | $85.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $181.97 Median $257.04 Typical High $316.23 | Professional | 54 · Surgery only | $181.97 | $257.04 | $316.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $51.29 Typical High $63.10 | Professional | 55 · Aftercare only | $36.31 | $51.29 | $63.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $34.67 Typical High $42.66 | Professional | 56 · Pre-op care only | $23.99 | $34.67 | $42.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $169.82 Median $239.88 Typical High $295.12 | Professional | 78 · Unplanned return to OR | $169.82 | $239.88 | $295.12 |
Where Virginia sits
The same service costs 5.5 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· 46th of 51
$288
AK $1,202TX $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.