How much rates vary
Facilitymedian $1,230 · 10th to 90th $158 to $4,786Professionalmedian $186 · 10th to 90th $138 to $269
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 $162.18 Median $4,073.80 Typical High $10,000.00 | Facility | None | $162.18 | $4,073.80 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $158.49 Median $194.98 Typical High $213.80 | Professional | None | $158.49 | $194.98 | $213.80 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,698.24 Median $2,398.83 Typical High $2,951.21 | Facility | None | $1,698.24 | $2,398.83 | $2,951.21 |
Anthem BCBS Setting Professional Modifier None Typical Low $138.04 Median $177.83 Typical High $234.42 | Professional | None | $138.04 | $177.83 | $234.42 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $87.10 Median $112.20 Typical High $147.91 | Professional | 62 · Two surgeons | $87.10 | $112.20 | $147.91 |
CareFirst Setting Professional Modifier None Typical Low $144.54 Median $158.49 Typical High $691.83 | Professional | None | $144.54 | $158.49 | $691.83 |
Cigna Setting Facility Modifier None Typical Low $91.20 Median $245.47 Typical High $1,621.81 | Facility | None | $91.20 | $245.47 | $1,621.81 |
Cigna Setting Professional Modifier None Typical Low $141.25 Median $190.55 Typical High $281.84 | Professional | None | $141.25 | $190.55 | $281.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $123.03 Median $218.78 Typical High $269.15 | Professional | None | $123.03 | $218.78 | $269.15 |
Medcost Setting Professional Modifier None Typical Low $213.80 Median $269.15 Typical High $269.15 | Professional | None | $213.80 | $269.15 | $269.15 |
Medcost Setting Facility Modifier None Typical Low $162.18 Median $213.80 Typical High $323.59 | Facility | None | $162.18 | $213.80 | $323.59 |
Medcost Setting Professional Modifier None Typical Low $234.42 Median $234.42 Typical High $234.42 | Professional | None | $234.42 | $234.42 | $234.42 |
Sentara Setting Facility Modifier None Typical Low $141.25 Median $616.60 Typical High $2,951.21 | Facility | None | $141.25 | $616.60 | $2,951.21 |
Sentara Setting Professional Modifier None Typical Low $169.82 Median $234.42 Typical High $1,737.80 | Professional | None | $169.82 | $234.42 | $1,737.80 |
United Setting Facility Modifier None Typical Low $323.59 Median $1,445.44 Typical High $3,630.78 | Facility | None | $323.59 | $1,445.44 | $3,630.78 |
United Setting Professional Modifier None Typical Low $123.03 Median $208.93 Typical High $316.23 | Professional | None | $123.03 | $208.93 | $316.23 |
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 $79.43 Median $87.10 Typical High $102.33 | Professional | 52 · Reduced service | $79.43 | $87.10 | $102.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $34.67 Typical High $40.74 | Professional | 53 · Discontinued | $31.62 | $34.67 | $40.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $131.83 Typical High $154.88 | Professional | 54 · Surgery only | $120.23 | $131.83 | $154.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $26.30 Typical High $30.90 | Professional | 55 · Aftercare only | $23.99 | $26.30 | $30.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $17.38 Typical High $20.42 | Professional | 56 · Pre-op care only | $15.85 | $17.38 | $20.42 |
Where Virginia sits
The same service costs 3.4 times more in Alaska than in Pennsylvania. 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· 40th of 51
$191
AK $575PA $170
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.