How much rates vary
Facilitymedian $562 · 10th to 90th $95 to $4,074Professionalmedian $138 · 10th to 90th $107 to $275
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 $134.90 Median $4,073.80 Typical High $10,000.00 | Facility | None | $134.90 | $4,073.80 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $117.49 Median $204.17 Typical High $234.42 | Professional | None | $117.49 | $204.17 | $234.42 |
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 $104.71 Median $125.89 Typical High $158.49 | Professional | None | $104.71 | $125.89 | $158.49 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $158.49 Median $186.21 Typical High $239.88 | Professional | 50 · Both sides | $158.49 | $186.21 | $239.88 |
CareFirst Setting Professional Modifier None Typical Low $107.15 Median $117.49 Typical High $691.83 | Professional | None | $107.15 | $117.49 | $691.83 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $134.90 Typical High $251.19 | Facility | None | $50.12 | $134.90 | $251.19 |
Cigna Setting Professional Modifier None Typical Low $112.20 Median $181.97 Typical High $281.84 | Professional | None | $112.20 | $181.97 | $281.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $100.00 Median $218.78 Typical High $275.42 | Professional | None | $100.00 | $218.78 | $275.42 |
Medcost Setting Professional Modifier None Typical Low $190.55 Median $239.88 Typical High $239.88 | Professional | None | $190.55 | $239.88 | $239.88 |
Medcost Setting Facility Modifier None Typical Low $117.49 Median $194.98 Typical High $331.13 | Facility | None | $117.49 | $194.98 | $331.13 |
Medcost Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $213.80 | Professional | None | $213.80 | $213.80 | $213.80 |
Sentara Setting Facility Modifier None Typical Low $91.20 Median $371.54 Typical High $2,454.71 | Facility | None | $91.20 | $371.54 | $2,454.71 |
Sentara Setting Professional Modifier None Typical Low $144.54 Median $229.09 Typical High $933.25 | Professional | None | $144.54 | $229.09 | $933.25 |
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 $87.10 Median $169.82 Typical High $316.23 | Professional | None | $87.10 | $169.82 | $316.23 |
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 $58.88 Median $74.13 Typical High $117.49 | Professional | 52 · Reduced service | $58.88 | $74.13 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $30.20 Typical High $46.77 | Professional | 53 · Discontinued | $23.44 | $30.20 | $46.77 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $89.13 Median $112.20 Typical High $173.78 | Professional | 54 · Surgery only | $89.13 | $112.20 | $173.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $22.39 Typical High $34.67 | Professional | 55 · Aftercare only | $17.78 | $22.39 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $15.14 Typical High $23.44 | Professional | 56 · Pre-op care only | $11.75 | $15.14 | $23.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $83.18 Median $104.71 Typical High $162.18 | Professional | 78 · Unplanned return to OR | $83.18 | $104.71 | $162.18 |
Where Virginia sits
The same service costs 4.5 times more in Alaska than in Kentucky. 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· 50th of 51
$148
AK $457KY $102
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.