How much rates vary
Facilitymedian $3,236 · 10th to 90th $417 to $10,965Professionalmedian $380 · 10th to 90th $309 to $589
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 $380.19 Median $3,981.07 Typical High $9,332.54 | Facility | None | $380.19 | $3,981.07 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $363.08 Median $380.19 Typical High $954.99 | Professional | None | $363.08 | $380.19 | $954.99 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,884.03 Median $3,715.35 Typical High $4,265.80 | Facility | None | $2,884.03 | $3,715.35 | $4,265.80 |
Anthem BCBS Setting Professional Modifier None Typical Low $309.03 Median $371.54 Typical High $467.74 | Professional | None | $309.03 | $371.54 | $467.74 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $467.74 Median $549.54 Typical High $707.95 | Professional | 50 · Both sides | $467.74 | $549.54 | $707.95 |
CareFirst Setting Professional Modifier None Typical Low $323.59 Median $363.08 Typical High $3,890.45 | Professional | None | $323.59 | $363.08 | $3,890.45 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $1,778.28 Typical High $3,235.94 | Facility | None | $524.81 | $1,778.28 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $323.59 Median $371.54 Typical High $562.34 | Professional | None | $323.59 | $371.54 | $562.34 |
Kaiser Permanente Setting Professional Modifier None Typical Low $295.12 Median $354.81 Typical High $436.52 | Professional | None | $295.12 | $354.81 | $436.52 |
Medcost Setting Professional Modifier None Typical Low $436.52 Median $549.54 Typical High $549.54 | Professional | None | $436.52 | $549.54 | $549.54 |
Medcost Setting Facility Modifier None Typical Low $371.54 Median $478.63 Typical High $602.56 | Facility | None | $371.54 | $478.63 | $602.56 |
Medcost Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $436.52 | Professional | None | $436.52 | $436.52 | $436.52 |
Sentara Setting Facility Modifier None Typical Low $309.03 Median $1,479.11 Typical High $10,232.93 | Facility | None | $309.03 | $1,479.11 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $323.59 Median $436.52 Typical High $6,025.60 | Professional | None | $323.59 | $436.52 | $6,025.60 |
United Setting Facility Modifier None Typical Low $1,548.82 Median $6,760.83 Typical High $16,595.87 | Facility | None | $1,548.82 | $6,760.83 | $16,595.87 |
United Setting Professional Modifier None Typical Low $269.15 Median $436.52 Typical High $660.69 | Professional | None | $269.15 | $436.52 | $660.69 |
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 $173.78 Median $186.21 Typical High $190.55 | Professional | 52 · Reduced service | $173.78 | $186.21 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $74.13 Typical High $75.86 | Professional | 53 · Discontinued | $69.18 | $74.13 | $75.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $275.42 Typical High $281.84 | Professional | 54 · Surgery only | $263.03 | $275.42 | $281.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $54.95 Typical High $57.54 | Professional | 55 · Aftercare only | $52.48 | $54.95 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $37.15 Typical High $38.02 | Professional | 56 · Pre-op care only | $34.67 | $37.15 | $38.02 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $245.47 Median $257.04 Typical High $263.03 | Professional | 78 · Unplanned return to OR | $245.47 | $257.04 | $263.03 |
Where Virginia sits
The same service costs 5.3 times more in Alaska than in Montana. 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.
Physician feeFacility fee
AK $5,518MT $1,050
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.