How much rates vary
Facilitymedian $1,622 · 10th to 90th $240 to $6,166Professionalmedian $257 · 10th to 90th $166 to $427
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 $1,096.48 Typical High $9,332.54 | Facility | None | $234.42 | $1,096.48 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $186.21 Median $281.84 Typical High $575.44 | Professional | None | $186.21 | $281.84 | $575.44 |
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 $162.18 Median $234.42 Typical High $331.13 | Professional | None | $162.18 | $234.42 | $331.13 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $239.88 Median $354.81 Typical High $501.19 | Professional | 50 · Both sides | $239.88 | $354.81 | $501.19 |
CareFirst Setting Professional Modifier None Typical Low $154.88 Median $173.78 Typical High $2,454.71 | Professional | None | $154.88 | $173.78 | $2,454.71 |
Cigna Setting Facility Modifier None Typical Low $346.74 Median $870.96 Typical High $1,659.59 | Facility | None | $346.74 | $870.96 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $169.82 Median $257.04 Typical High $426.58 | Professional | None | $169.82 | $257.04 | $426.58 |
Kaiser Permanente Setting Professional Modifier None Typical Low $141.25 Median $302.00 Typical High $371.54 | Professional | None | $141.25 | $302.00 | $371.54 |
Medcost Setting Professional Modifier None Typical Low $416.87 Median $524.81 Typical High $524.81 | Professional | None | $416.87 | $524.81 | $524.81 |
Medcost Setting Facility Modifier None Typical Low $186.21 Median $281.84 Typical High $457.09 | Facility | None | $186.21 | $281.84 | $457.09 |
Medcost Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $407.38 | Professional | None | $407.38 | $407.38 | $407.38 |
Sentara Setting Facility Modifier None Typical Low $173.78 Median $912.01 Typical High $3,801.89 | Facility | None | $173.78 | $912.01 | $3,801.89 |
Sentara Setting Professional Modifier None Typical Low $263.03 Median $380.19 Typical High $2,137.96 | Professional | None | $263.03 | $380.19 | $2,137.96 |
United Setting Facility Modifier None Typical Low $588.84 Median $2,344.23 Typical High $6,165.95 | Facility | None | $588.84 | $2,344.23 | $6,165.95 |
United Setting Professional Modifier None Typical Low $154.88 Median $281.84 Typical High $467.74 | Professional | None | $154.88 | $281.84 | $467.74 |
5 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 $93.33 Median $112.20 Typical High $154.88 | Professional | 52 · Reduced service | $93.33 | $112.20 | $154.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $44.67 Typical High $61.66 | Professional | 53 · Discontinued | $38.02 | $44.67 | $61.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $165.96 Typical High $229.09 | Professional | 54 · Surgery only | $141.25 | $165.96 | $229.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $33.88 Typical High $45.71 | Professional | 55 · Aftercare only | $28.18 | $33.88 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $22.39 Typical High $30.90 | Professional | 56 · Pre-op care only | $18.62 | $22.39 | $30.90 |
Where Virginia sits
The same service costs 3.1 times more in Alaska than in New York. 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· 48th of 51
$269
AK $794NY $257
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.