How much rates vary
Facilitymedian $3,548 · 10th to 90th $407 to $10,000Professionalmedian $407 · 10th to 90th $324 to $646
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 $407.38 Median $4,365.16 Typical High $10,000.00 | Facility | None | $407.38 | $4,365.16 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $371.54 Median $407.38 Typical High $2,630.27 | Professional | None | $371.54 | $407.38 | $2,630.27 |
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 $323.59 Median $389.05 Typical High $501.19 | Professional | None | $323.59 | $389.05 | $501.19 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $489.78 Median $588.84 Typical High $758.58 | Professional | 50 · Both sides | $489.78 | $588.84 | $758.58 |
CareFirst Setting Professional Modifier None Typical Low $338.84 Median $371.54 Typical High $5,495.41 | Professional | None | $338.84 | $371.54 | $5,495.41 |
Cigna Setting Facility Modifier None Typical Low $346.74 Median $2,454.71 Typical High $5,128.61 | Facility | None | $346.74 | $2,454.71 | $5,128.61 |
Cigna Setting Professional Modifier None Typical Low $338.84 Median $416.87 Typical High $616.60 | Professional | None | $338.84 | $416.87 | $616.60 |
Kaiser Permanente Setting Professional Modifier None Typical Low $302.00 Median $354.81 Typical High $446.68 | Professional | None | $302.00 | $354.81 | $446.68 |
Medcost Setting Professional Modifier None Typical Low $501.19 Median $630.96 Typical High $630.96 | Professional | None | $501.19 | $630.96 | $630.96 |
Medcost Setting Facility Modifier None Typical Low $407.38 Median $537.03 Typical High $660.69 | Facility | None | $407.38 | $537.03 | $660.69 |
Medcost Setting Professional Modifier None Typical Low $489.78 Median $489.78 Typical High $489.78 | Professional | None | $489.78 | $489.78 | $489.78 |
Sentara Setting Facility Modifier None Typical Low $338.84 Median $1,445.44 Typical High $8,709.64 | Facility | None | $338.84 | $1,445.44 | $8,709.64 |
Sentara Setting Professional Modifier None Typical Low $338.84 Median $467.74 Typical High $4,073.80 | Professional | None | $338.84 | $467.74 | $4,073.80 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $5,011.87 Typical High $13,182.57 | Facility | None | $1,230.27 | $5,011.87 | $13,182.57 |
United Setting Professional Modifier None Typical Low $295.12 Median $478.63 Typical High $724.44 | Professional | None | $295.12 | $478.63 | $724.44 |
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 $186.21 Median $204.17 Typical High $204.17 | Professional | 52 · Reduced service | $186.21 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $81.28 Typical High $81.28 | Professional | 53 · Discontinued | $74.13 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $281.84 Median $302.00 Typical High $302.00 | Professional | 54 · Surgery only | $281.84 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $60.26 Typical High $60.26 | Professional | 55 · Aftercare only | $56.23 | $60.26 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $40.74 Typical High $40.74 | Professional | 56 · Pre-op care only | $37.15 | $40.74 | $40.74 |
Where Virginia sits
The same service costs 7.8 times more in Oklahoma 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· 47th of 51
$417
OK $2,630NY $339
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.