How much rates vary
Facilitymedian $3,890 · 10th to 90th $501 to $12,882Professionalmedian $1,122 · 10th to 90th $380 to $1,995
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 $741.31 Median $4,786.30 Typical High $12,302.69 | Facility | None | $741.31 | $4,786.30 | $12,302.69 |
Aetna Setting Professional Modifier None Typical Low $426.58 Median $1,445.44 Typical High $2,290.87 | Professional | None | $426.58 | $1,445.44 | $2,290.87 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,754.40 Median $8,317.64 Typical High $11,481.54 | Facility | None | $5,754.40 | $8,317.64 | $11,481.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $380.19 Median $977.24 Typical High $1,548.82 | Professional | None | $380.19 | $977.24 | $1,548.82 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $562.34 Median $1,318.26 Typical High $2,344.23 | Professional | 50 · Both sides | $562.34 | $1,318.26 | $2,344.23 |
CareFirst Setting Professional Modifier None Typical Low $371.54 Median $416.87 Typical High $4,168.69 | Professional | None | $371.54 | $416.87 | $4,168.69 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $1,659.59 Typical High $3,090.30 | Facility | None | $524.81 | $1,659.59 | $3,090.30 |
Cigna Setting Professional Modifier None Typical Low $380.19 Median $1,000.00 Typical High $1,862.09 | Professional | None | $380.19 | $1,000.00 | $1,862.09 |
Kaiser Permanente Setting Professional Modifier None Typical Low $346.74 Median $1,584.89 Typical High $1,949.84 | Professional | None | $346.74 | $1,584.89 | $1,949.84 |
Medcost Setting Professional Modifier None Typical Low $1,659.59 Median $2,089.30 Typical High $2,089.30 | Professional | None | $1,659.59 | $2,089.30 | $2,089.30 |
Medcost Setting Facility Modifier None Typical Low $426.58 Median $707.95 Typical High $2,344.23 | Facility | None | $426.58 | $707.95 | $2,344.23 |
Medcost Setting Professional Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $1,380.38 | Professional | None | $1,380.38 | $1,380.38 | $1,380.38 |
Sentara Setting Facility Modifier None Typical Low $346.74 Median $1,778.28 Typical High $10,232.93 | Facility | None | $346.74 | $1,778.28 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $1,258.93 Median $1,778.28 Typical High $10,000.00 | Professional | None | $1,258.93 | $1,778.28 | $10,000.00 |
United Setting Facility Modifier None Typical Low $1,548.82 Median $6,760.83 Typical High $17,378.01 | Facility | None | $1,548.82 | $6,760.83 | $17,378.01 |
United Setting Professional Modifier None Typical Low $363.08 Median $954.99 Typical High $2,344.23 | Professional | None | $363.08 | $954.99 | $2,344.23 |
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 $213.80 Median $389.05 Typical High $831.76 | Professional | 52 · Reduced service | $213.80 | $389.05 | $831.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $85.11 Median $154.88 Typical High $331.13 | Professional | 53 · Discontinued | $85.11 | $154.88 | $331.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $323.59 Median $575.44 Typical High $1,258.93 | Professional | 54 · Surgery only | $323.59 | $575.44 | $1,258.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $114.82 Typical High $251.19 | Professional | 55 · Aftercare only | $64.57 | $114.82 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $77.62 Typical High $165.96 | Professional | 56 · Pre-op care only | $42.66 | $77.62 | $165.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $302.00 Median $537.03 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $302.00 | $537.03 | $1,174.90 |
Where Virginia sits
The same service costs 4.4 times more in Alaska 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· 43rd of 51
$1,230
AK $3,020NE $692
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.