How much rates vary
Facilitymedian $1,820 · 10th to 90th $234 to $5,754Professionalmedian $219 · 10th to 90th $178 to $339
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 $234.42 Median $4,365.16 Typical High $14,125.38 | Facility | None | $234.42 | $4,365.16 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $208.93 Median $208.93 Typical High $2,570.40 | Professional | None | $208.93 | $208.93 | $2,570.40 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,884.03 Median $3,715.35 Typical High $4,265.80 | Facility | None | $2,884.03 | $3,715.35 | $4,265.80 |
Anthem BCBS Setting Professional Modifier None Typical Low $177.83 Median $213.80 Typical High $275.42 | Professional | None | $177.83 | $213.80 | $275.42 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $269.15 Median $316.23 Typical High $407.38 | Professional | 50 · Both sides | $269.15 | $316.23 | $407.38 |
CareFirst Setting Professional Modifier None Typical Low $186.21 Median $208.93 Typical High $691.83 | Professional | None | $186.21 | $208.93 | $691.83 |
Cigna Setting Facility Modifier None Typical Low $346.74 Median $741.31 Typical High $1,659.59 | Facility | None | $346.74 | $741.31 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $181.97 Median $229.09 Typical High $338.84 | Professional | None | $181.97 | $229.09 | $338.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $162.18 Median $194.98 Typical High $239.88 | Professional | None | $162.18 | $194.98 | $239.88 |
Medcost Setting Professional Modifier None Typical Low $251.19 Median $316.23 Typical High $316.23 | Professional | None | $251.19 | $316.23 | $316.23 |
Medcost Setting Facility Modifier None Typical Low $208.93 Median $257.04 Typical High $346.74 | Facility | None | $208.93 | $257.04 | $346.74 |
Medcost Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $245.47 | Professional | None | $245.47 | $245.47 | $245.47 |
Sentara Setting Facility Modifier None Typical Low $162.18 Median $933.25 Typical High $3,630.78 | Facility | None | $162.18 | $933.25 | $3,630.78 |
Sentara Setting Professional Modifier None Typical Low $162.18 Median $251.19 Typical High $2,137.96 | Professional | None | $162.18 | $251.19 | $2,137.96 |
United Setting Facility Modifier None Typical Low $588.84 Median $2,187.76 Typical High $5,888.44 | Facility | None | $588.84 | $2,187.76 | $5,888.44 |
United Setting Professional Modifier None Typical Low $154.88 Median $257.04 Typical High $380.19 | Professional | None | $154.88 | $257.04 | $380.19 |
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 $104.71 Median $104.71 Typical High $117.49 | Professional | 52 · Reduced service | $104.71 | $104.71 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $42.66 Typical High $46.77 | Professional | 53 · Discontinued | $41.69 | $42.66 | $46.77 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $158.49 Median $158.49 Typical High $177.83 | Professional | 54 · Surgery only | $158.49 | $158.49 | $177.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $31.62 Typical High $35.48 | Professional | 55 · Aftercare only | $31.62 | $31.62 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $20.89 Typical High $23.44 | Professional | 56 · Pre-op care only | $20.89 | $20.89 | $23.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $147.91 Median $147.91 Typical High $165.96 | Professional | 78 · Unplanned return to OR | $147.91 | $147.91 | $165.96 |
Where Virginia sits
The same service costs 8.9 times more in Oklahoma than in Utah. 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· 44th of 51
$229
OK $1,413UT $158
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.