How much rates vary
Facilitymedian $513 · 10th to 90th $135 to $4,074Professionalmedian $224 · 10th to 90th $166 to $331
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 $213.80 Median $4,073.80 Typical High $10,000.00 | Facility | None | $213.80 | $4,073.80 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $213.80 Median $257.04 Typical High $257.04 | Professional | None | $213.80 | $257.04 | $257.04 |
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 $190.55 Median $229.09 Typical High $275.42 | Professional | None | $190.55 | $229.09 | $275.42 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $288.40 Median $346.74 Typical High $416.87 | Professional | 50 · Both sides | $288.40 | $346.74 | $416.87 |
CareFirst Setting Professional Modifier None Typical Low $218.78 Median $245.47 Typical High $288.40 | Professional | None | $218.78 | $245.47 | $288.40 |
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 $162.18 Median $213.80 Typical High $354.81 | Professional | None | $162.18 | $213.80 | $354.81 |
Kaiser Permanente Setting Professional Modifier None Typical Low $263.03 Median $309.03 Typical High $398.11 | Professional | None | $263.03 | $309.03 | $398.11 |
Medcost Setting Professional Modifier None Typical Low $208.93 Median $263.03 Typical High $269.15 | Professional | None | $208.93 | $263.03 | $269.15 |
Medcost Setting Facility Modifier None Typical Low $194.98 Median $218.78 Typical High $416.87 | Facility | None | $194.98 | $218.78 | $416.87 |
Medcost Setting Professional Modifier None Typical Low $194.98 Median $199.53 Typical High $218.78 | Professional | None | $194.98 | $199.53 | $218.78 |
Sentara Setting Facility Modifier None Typical Low $173.78 Median $380.19 Typical High $2,454.71 | Facility | None | $173.78 | $380.19 | $2,454.71 |
Sentara Setting Professional Modifier None Typical Low $177.83 Median $234.42 Typical High $562.34 | Professional | None | $177.83 | $234.42 | $562.34 |
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 $134.90 Median $190.55 Typical High $389.05 | Professional | None | $134.90 | $190.55 | $389.05 |
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 $107.15 Median $114.82 Typical High $128.82 | Professional | 52 · Reduced service | $107.15 | $114.82 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $42.66 Median $45.71 Typical High $51.29 | Professional | 53 · Discontinued | $42.66 | $45.71 | $51.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $162.18 Median $173.78 Typical High $194.98 | Professional | 54 · Surgery only | $162.18 | $173.78 | $194.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $32.36 Median $34.67 Typical High $38.90 | Professional | 55 · Aftercare only | $32.36 | $34.67 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.38 Median $22.91 Typical High $25.70 | Professional | 56 · Pre-op care only | $21.38 | $22.91 | $25.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $151.36 Median $162.18 Typical High $181.97 | Professional | 78 · Unplanned return to OR | $151.36 | $162.18 | $181.97 |
Where Virginia sits
The same service costs 5.0 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· 34th of 51
$229
AK $832FL $166
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.