How much rates vary
Facilitymedian $3,981 · 10th to 90th $447 to $12,882Professionalmedian $1,288 · 10th to 90th $331 to $2,239
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 $1,230.27 Median $5,248.07 Typical High $14,125.38 | Facility | None | $1,230.27 | $5,248.07 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $371.54 Median $1,584.89 Typical High $2,884.03 | Professional | None | $371.54 | $1,584.89 | $2,884.03 |
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 $331.13 Median $851.14 Typical High $1,819.70 | Professional | None | $331.13 | $851.14 | $1,819.70 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $489.78 Median $1,258.93 Typical High $2,754.23 | Professional | 50 · Both sides | $489.78 | $1,258.93 | $2,754.23 |
CareFirst Setting Professional Modifier None Typical Low $323.59 Median $363.08 Typical High $3,715.35 | Professional | None | $323.59 | $363.08 | $3,715.35 |
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 $331.13 Median $912.01 Typical High $2,187.76 | Professional | None | $331.13 | $912.01 | $2,187.76 |
Kaiser Permanente Setting Professional Modifier None Typical Low $302.00 Median $1,862.09 Typical High $2,290.87 | Professional | None | $302.00 | $1,862.09 | $2,290.87 |
Medcost Setting Professional Modifier None Typical Low $1,737.80 Median $2,187.76 Typical High $2,398.83 | Professional | None | $1,737.80 | $2,187.76 | $2,398.83 |
Medcost Setting Facility Modifier None Typical Low $371.54 Median $602.56 Typical High $2,630.27 | Facility | None | $371.54 | $602.56 | $2,630.27 |
Medcost Setting Professional Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $1,412.54 | Professional | None | $1,412.54 | $1,412.54 | $1,412.54 |
Sentara Setting Facility Modifier None Typical Low $302.00 Median $1,737.80 Typical High $10,232.93 | Facility | None | $302.00 | $1,737.80 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $1,348.96 Median $1,949.84 Typical High $10,000.00 | Professional | None | $1,348.96 | $1,949.84 | $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 $323.59 Median $977.24 Typical High $2,630.27 | Professional | None | $323.59 | $977.24 | $2,630.27 |
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 $186.21 Median $371.54 Typical High $1,000.00 | Professional | 52 · Reduced service | $186.21 | $371.54 | $1,000.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $147.91 Typical High $398.11 | Professional | 53 · Discontinued | $74.13 | $147.91 | $398.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $281.84 Median $549.54 Typical High $1,479.11 | Professional | 54 · Surgery only | $281.84 | $549.54 | $1,479.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $109.65 Typical High $295.12 | Professional | 55 · Aftercare only | $56.23 | $109.65 | $295.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $74.13 Typical High $199.53 | Professional | 56 · Pre-op care only | $37.15 | $74.13 | $199.53 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $263.03 Median $512.86 Typical High $1,380.38 | Professional | 78 · Unplanned return to OR | $263.03 | $512.86 | $1,380.38 |
Where Virginia sits
The same service costs 5.8 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· 35th of 51
$1,413
AK $3,548NE $617
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.