How much rates vary
Facilitymedian $2,188 · 10th to 90th $200 to $7,079Professionalmedian $1,259 · 10th to 90th $148 to $2,399
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 $186.21 Median $4,365.16 Typical High $10,000.00 | Facility | None | $186.21 | $4,365.16 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $169.82 Median $1,737.80 Typical High $3,162.28 | Professional | None | $169.82 | $1,737.80 | $3,162.28 |
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 $147.91 Median $512.86 Typical High $1,737.80 | Professional | None | $147.91 | $512.86 | $1,737.80 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $218.78 Median $776.25 Typical High $2,570.40 | Professional | 50 · Both sides | $218.78 | $776.25 | $2,570.40 |
CareFirst Setting Professional Modifier None Typical Low $144.54 Median $158.49 Typical High $2,951.21 | Professional | None | $144.54 | $158.49 | $2,951.21 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $1,318.26 Typical High $3,548.13 | Facility | None | $524.81 | $1,318.26 | $3,548.13 |
Cigna Setting Professional Modifier None Typical Low $147.91 Median $426.58 Typical High $2,398.83 | Professional | None | $147.91 | $426.58 | $2,398.83 |
Kaiser Permanente Setting Professional Modifier None Typical Low $125.89 Median $1,584.89 Typical High $1,949.84 | Professional | None | $125.89 | $1,584.89 | $1,949.84 |
Medcost Setting Facility Modifier None Typical Low $169.82 Median $281.84 Typical High $2,951.21 | Facility | None | $169.82 | $281.84 | $2,951.21 |
Medcost Setting Professional Modifier None Typical Low $2,187.76 Median $2,187.76 Typical High $2,187.76 | Professional | None | $2,187.76 | $2,187.76 | $2,187.76 |
Sentara Setting Facility Modifier None Typical Low $154.88 Median $1,445.44 Typical High $8,709.64 | Facility | None | $154.88 | $1,445.44 | $8,709.64 |
Sentara Setting Professional Modifier None Typical Low $1,548.82 Median $2,187.76 Typical High $8,511.38 | Professional | None | $1,548.82 | $2,187.76 | $8,511.38 |
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 $457.09 Typical High $3,019.95 | Professional | None | $154.88 | $457.09 | $3,019.95 |
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 $85.11 Median $169.82 Typical High $954.99 | Professional | 52 · Reduced service | $85.11 | $169.82 | $954.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $67.61 Typical High $389.05 | Professional | 53 · Discontinued | $34.67 | $67.61 | $389.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $251.19 Typical High $1,445.44 | Professional | 54 · Surgery only | $128.82 | $251.19 | $1,445.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $50.12 Typical High $288.40 | Professional | 55 · Aftercare only | $25.70 | $50.12 | $288.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $33.88 Typical High $194.98 | Professional | 56 · Pre-op care only | $16.98 | $33.88 | $194.98 |
Where Virginia sits
The same service costs 8.5 times more in Wisconsin than in Nebraska. 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· 31st of 51
$1,318
WI $2,291NE $269
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.