How much rates vary
Facilitymedian $407 · 10th to 90th $129 to $3,802Professionalmedian $178 · 10th to 90th $138 to $263
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 $199.53 Median $398.11 Typical High $8,317.64 | Facility | None | $199.53 | $398.11 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $158.49 Median $190.55 Typical High $269.15 | Professional | None | $158.49 | $190.55 | $269.15 |
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 $144.54 Median $173.78 Typical High $204.17 | Professional | None | $144.54 | $173.78 | $204.17 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $213.80 Median $257.04 Typical High $309.03 | Professional | 50 · Both sides | $213.80 | $257.04 | $309.03 |
CareFirst Setting Professional Modifier None Typical Low $165.96 Median $181.97 Typical High $213.80 | Professional | None | $165.96 | $181.97 | $213.80 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $141.25 Typical High $263.03 | Facility | None | $50.12 | $141.25 | $263.03 |
Cigna Setting Professional Modifier None Typical Low $151.36 Median $181.97 Typical High $281.84 | Professional | None | $151.36 | $181.97 | $281.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $190.55 Median $229.09 Typical High $288.40 | Professional | None | $190.55 | $229.09 | $288.40 |
Medcost Setting Professional Modifier None Typical Low $194.98 Median $239.88 Typical High $239.88 | Professional | None | $194.98 | $239.88 | $239.88 |
Medcost Setting Facility Modifier None Typical Low $165.96 Median $199.53 Typical High $331.13 | Facility | None | $165.96 | $199.53 | $331.13 |
Medcost Setting Professional Modifier None Typical Low $120.23 Median $158.49 Typical High $204.17 | Professional | None | $120.23 | $158.49 | $204.17 |
Sentara Setting Facility Modifier None Typical Low $138.04 Median $371.54 Typical High $2,454.71 | Facility | None | $138.04 | $371.54 | $2,454.71 |
Sentara Setting Professional Modifier None Typical Low $138.04 Median $199.53 Typical High $436.52 | Professional | None | $138.04 | $199.53 | $436.52 |
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 $112.20 Median $162.18 Typical High $302.00 | Professional | None | $112.20 | $162.18 | $302.00 |
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 $79.43 Median $89.13 Typical High $100.00 | Professional | 52 · Reduced service | $79.43 | $89.13 | $100.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $35.48 Typical High $39.81 | Professional | 53 · Discontinued | $31.62 | $35.48 | $39.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $134.90 Typical High $151.36 | Professional | 54 · Surgery only | $120.23 | $134.90 | $151.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $26.92 Typical High $30.20 | Professional | 55 · Aftercare only | $23.99 | $26.92 | $30.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $17.78 Typical High $19.95 | Professional | 56 · Pre-op care only | $15.85 | $17.78 | $19.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $112.20 Median $125.89 Typical High $141.25 | Professional | 78 · Unplanned return to OR | $112.20 | $125.89 | $141.25 |
Where Virginia sits
The same service costs 4.6 times more in Alaska than in Florida. 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· 36th of 51
$182
AK $617FL $135
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.