How much rates vary
Facilitymedian $2,344 · 10th to 90th $575 to $8,511Professionalmedian $646 · 10th to 90th $513 to $1,000
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 $645.65 Median $4,786.30 Typical High $10,000.00 | Facility | None | $645.65 | $4,786.30 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $588.84 Median $645.65 Typical High $2,570.40 | Professional | None | $588.84 | $645.65 | $2,570.40 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,165.95 Median $7,413.10 Typical High $9,549.93 | Facility | None | $6,165.95 | $7,413.10 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $512.86 Median $616.60 Typical High $794.33 | Professional | None | $512.86 | $616.60 | $794.33 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $776.25 Median $933.25 Typical High $1,174.90 | Professional | 50 · Both sides | $776.25 | $933.25 | $1,174.90 |
CareFirst Setting Professional Modifier None Typical Low $537.03 Median $588.84 Typical High $6,918.31 | Professional | None | $537.03 | $588.84 | $6,918.31 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $4,786.30 Typical High $9,549.93 | Facility | None | $512.86 | $4,786.30 | $9,549.93 |
Cigna Setting Professional Modifier None Typical Low $537.03 Median $645.65 Typical High $977.24 | Professional | None | $537.03 | $645.65 | $977.24 |
Kaiser Permanente Setting Professional Modifier None Typical Low $478.63 Median $562.34 Typical High $707.95 | Professional | None | $478.63 | $562.34 | $707.95 |
Medcost Setting Professional Modifier None Typical Low $794.33 Median $1,000.00 Typical High $1,000.00 | Professional | None | $794.33 | $1,000.00 | $1,000.00 |
Medcost Setting Facility Modifier None Typical Low $645.65 Median $851.14 Typical High $1,047.13 | Facility | None | $645.65 | $851.14 | $1,047.13 |
Medcost Setting Professional Modifier None Typical Low $776.25 Median $776.25 Typical High $776.25 | Professional | None | $776.25 | $776.25 | $776.25 |
Sentara Setting Facility Modifier None Typical Low $537.03 Median $1,071.52 Typical High $3,715.35 | Facility | None | $537.03 | $1,071.52 | $3,715.35 |
Sentara Setting Professional Modifier None Typical Low $549.54 Median $758.58 Typical High $2,570.40 | Professional | None | $549.54 | $758.58 | $2,570.40 |
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 $467.74 Median $758.58 Typical High $1,148.15 | Professional | None | $467.74 | $758.58 | $1,148.15 |
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 $295.12 Median $323.59 Typical High $323.59 | Professional | 52 · Reduced service | $295.12 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $117.49 Median $128.82 Typical High $128.82 | Professional | 53 · Discontinued | $117.49 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $478.63 Typical High $478.63 | Professional | 54 · Surgery only | $436.52 | $478.63 | $478.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $95.50 Typical High $95.50 | Professional | 55 · Aftercare only | $87.10 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $64.57 Typical High $64.57 | Professional | 56 · Pre-op care only | $58.88 | $64.57 | $64.57 |
Where Virginia sits
The same service costs 3.9 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· 46th of 51
$646
AK $2,239NY $575
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.