How much rates vary
Facilitymedian $501 · 10th to 90th $93 to $4,074Professionalmedian $120 · 10th to 90th $91 to $174
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 $114.82 Median $4,073.80 Typical High $10,000.00 | Facility | None | $114.82 | $4,073.80 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $107.15 Median $123.03 Typical High $154.88 | Professional | None | $107.15 | $123.03 | $154.88 |
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 $97.72 Median $117.49 Typical High $141.25 | Professional | None | $97.72 | $117.49 | $141.25 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $147.91 Median $177.83 Typical High $213.80 | Professional | 50 · Both sides | $147.91 | $177.83 | $213.80 |
CareFirst Setting Professional Modifier None Typical Low $114.82 Median $125.89 Typical High $147.91 | Professional | None | $114.82 | $125.89 | $147.91 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $87.10 Typical High $162.18 | Facility | None | $50.12 | $87.10 | $162.18 |
Cigna Setting Professional Modifier None Typical Low $102.33 Median $123.03 Typical High $181.97 | Professional | None | $102.33 | $123.03 | $181.97 |
Kaiser Permanente Setting Professional Modifier None Typical Low $120.23 Median $144.54 Typical High $181.97 | Professional | None | $120.23 | $144.54 | $181.97 |
Medcost Setting Professional Modifier None Typical Low $128.82 Median $162.18 Typical High $186.21 | Professional | None | $128.82 | $162.18 | $186.21 |
Medcost Setting Facility Modifier None Typical Low $114.82 Median $131.83 Typical High $213.80 | Facility | None | $114.82 | $131.83 | $213.80 |
Medcost Setting Professional Modifier None Typical Low $123.03 Median $134.90 Typical High $134.90 | Professional | None | $123.03 | $134.90 | $134.90 |
Sentara Setting Facility Modifier None Typical Low $95.50 Median $371.54 Typical High $2,454.71 | Facility | None | $95.50 | $371.54 | $2,454.71 |
Sentara Setting Professional Modifier None Typical Low $114.82 Median $138.04 Typical High $281.84 | Professional | None | $114.82 | $138.04 | $281.84 |
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 $72.44 Median $104.71 Typical High $204.17 | Professional | None | $72.44 | $104.71 | $204.17 |
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 $53.70 Median $57.54 Typical High $66.07 | Professional | 52 · Reduced service | $53.70 | $57.54 | $66.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $23.44 Typical High $26.30 | Professional | 53 · Discontinued | $21.38 | $23.44 | $26.30 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $81.28 Median $87.10 Typical High $97.72 | Professional | 54 · Surgery only | $81.28 | $87.10 | $97.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $17.38 Typical High $19.50 | Professional | 55 · Aftercare only | $16.22 | $17.38 | $19.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $11.48 Typical High $13.18 | Professional | 56 · Pre-op care only | $10.72 | $11.48 | $13.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $75.86 Median $81.28 Typical High $91.20 | Professional | 78 · Unplanned return to OR | $75.86 | $81.28 | $91.20 |
Where Virginia sits
The same service costs 4.5 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· 37th of 51
$123
AK $427FL $95.50
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.