How much rates vary
Facilitymedian $5,888 · 10th to 90th $324 to $14,791Professionalmedian $1,072 · 10th to 90th $275 to $1,862
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 $616.60 Median $4,073.80 Typical High $9,332.54 | Facility | None | $616.60 | $4,073.80 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $323.59 Median $1,230.27 Typical High $1,621.81 | Professional | None | $323.59 | $1,230.27 | $1,621.81 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,011.87 Median $6,606.93 Typical High $7,244.36 | Facility | None | $5,011.87 | $6,606.93 | $7,244.36 |
Anthem BCBS Setting Professional Modifier None Typical Low $275.42 Median $977.24 Typical High $1,584.89 | Professional | None | $275.42 | $977.24 | $1,584.89 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $416.87 Median $1,445.44 Typical High $2,344.23 | Professional | 50 · Both sides | $416.87 | $1,445.44 | $2,344.23 |
CareFirst Setting Professional Modifier None Typical Low $269.15 Median $302.00 Typical High $354.81 | Professional | None | $269.15 | $302.00 | $354.81 |
Cigna Setting Professional Modifier None Typical Low $269.15 Median $758.58 Typical High $2,137.96 | Professional | None | $269.15 | $758.58 | $2,137.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,230.27 Median $1,445.44 Typical High $1,819.70 | Professional | None | $1,230.27 | $1,445.44 | $1,819.70 |
Medcost Setting Professional Modifier None Typical Low $3,090.30 Median $3,090.30 Typical High $3,090.30 | Professional | None | $3,090.30 | $3,090.30 | $3,090.30 |
Medcost Setting Facility Modifier None Typical Low $389.05 Median $524.81 Typical High $2,238.72 | Facility | None | $389.05 | $524.81 | $2,238.72 |
Medcost Setting Professional Modifier None Typical Low $1,122.02 Median $1,862.09 Typical High $2,344.23 | Professional | None | $1,122.02 | $1,862.09 | $2,344.23 |
Sentara Setting Facility Modifier None Typical Low $251.19 Median $537.03 Typical High $10,964.78 | Facility | None | $251.19 | $537.03 | $10,964.78 |
Sentara Setting Professional Modifier None Typical Low $1,318.26 Median $1,698.24 Typical High $3,235.94 | Professional | None | $1,318.26 | $1,698.24 | $3,235.94 |
United Setting Facility Modifier None Typical Low $5,754.40 Median $9,772.37 Typical High $19,952.62 | Facility | None | $5,754.40 | $9,772.37 | $19,952.62 |
United Setting Professional Modifier None Typical Low $269.15 Median $1,000.00 Typical High $2,454.71 | Professional | None | $269.15 | $1,000.00 | $2,454.71 |
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 $158.49 Median $251.19 Typical High $812.83 | Professional | 52 · Reduced service | $158.49 | $251.19 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $100.00 Typical High $331.13 | Professional | 53 · Discontinued | $64.57 | $100.00 | $331.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $380.19 Typical High $1,230.27 | Professional | 54 · Surgery only | $239.88 | $380.19 | $1,230.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $75.86 Typical High $245.47 | Professional | 55 · Aftercare only | $47.86 | $75.86 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $50.12 Typical High $162.18 | Professional | 56 · Pre-op care only | $32.36 | $50.12 | $162.18 |
Where Virginia sits
The same service costs 5.1 times more in Wisconsin than in Maryland. 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
$1,122
WI $2,042MD $398
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.