How much rates vary
Facilitymedian $2,042 · 10th to 90th $98 to $6,457Professionalmedian $85 · 10th to 90th $69 to $138
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 $85.11 Median $4,073.80 Typical High $10,000.00 | Facility | None | $85.11 | $4,073.80 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $83.18 Median $85.11 Typical High $2,570.40 | Professional | None | $83.18 | $85.11 | $2,570.40 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,677.35 Median $6,456.54 Typical High $7,244.36 | Facility | None | $4,677.35 | $6,456.54 | $7,244.36 |
Anthem BCBS Setting Professional Modifier None Typical Low $69.18 Median $83.18 Typical High $107.15 | Professional | None | $69.18 | $83.18 | $107.15 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $104.71 Median $123.03 Typical High $158.49 | Professional | 50 · Both sides | $104.71 | $123.03 | $158.49 |
CareFirst Setting Professional Modifier None Typical Low $72.44 Median $79.43 Typical High $3,467.37 | Professional | None | $72.44 | $79.43 | $3,467.37 |
Cigna Setting Facility Modifier None Typical Low $346.74 Median $1,258.93 Typical High $2,344.23 | Facility | None | $346.74 | $1,258.93 | $2,344.23 |
Cigna Setting Professional Modifier None Typical Low $72.44 Median $87.10 Typical High $134.90 | Professional | None | $72.44 | $87.10 | $134.90 |
Kaiser Permanente Setting Professional Modifier None Typical Low $64.57 Median $77.62 Typical High $95.50 | Professional | None | $64.57 | $77.62 | $95.50 |
Medcost Setting Professional Modifier None Typical Low $102.33 Median $128.82 Typical High $128.82 | Professional | None | $102.33 | $128.82 | $128.82 |
Medcost Setting Facility Modifier None Typical Low $85.11 Median $112.20 Typical High $138.04 | Facility | None | $85.11 | $112.20 | $138.04 |
Medcost Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $102.33 | Professional | None | $102.33 | $102.33 | $102.33 |
Sentara Setting Facility Modifier None Typical Low $72.44 Median $891.25 Typical High $3,630.78 | Facility | None | $72.44 | $891.25 | $3,630.78 |
Sentara Setting Professional Modifier None Typical Low $74.13 Median $102.33 Typical High $2,137.96 | Professional | None | $74.13 | $102.33 | $2,137.96 |
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 $61.66 Median $100.00 Typical High $151.36 | Professional | None | $61.66 | $100.00 | $151.36 |
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 $39.81 Median $42.66 Typical High $42.66 | Professional | 52 · Reduced service | $39.81 | $42.66 | $42.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.85 Median $16.98 Typical High $16.98 | Professional | 53 · Discontinued | $15.85 | $16.98 | $16.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $58.88 Median $63.10 Typical High $64.57 | Professional | 54 · Surgery only | $58.88 | $63.10 | $64.57 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $12.59 Typical High $12.88 | Professional | 55 · Aftercare only | $11.75 | $12.59 | $12.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $8.51 Typical High $8.51 | Professional | 56 · Pre-op care only | $7.94 | $8.51 | $8.51 |
Where Virginia sits
The same service costs 11.2 times more in Tennessee 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
$87.10
TN $832NY $74.13
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.