How much rates vary
Facilitymedian $1,585 · 10th to 90th $324 to $10,233Professionalmedian $398 · 10th to 90th $269 to $617
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 $338.84 Median $3,981.07 Typical High $9,332.54 | Facility | None | $338.84 | $3,981.07 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $234.42 Median $338.84 Typical High $645.65 | Professional | None | $234.42 | $338.84 | $645.65 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,456.54 Median $9,332.54 Typical High $22,387.21 | Facility | None | $6,456.54 | $9,332.54 | $22,387.21 |
Anthem BCBS Setting Professional Modifier None Typical Low $281.84 Median $371.54 Typical High $524.81 | Professional | None | $281.84 | $371.54 | $524.81 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $173.78 Median $234.42 Typical High $331.13 | Professional | 62 · Two surgeons | $173.78 | $234.42 | $331.13 |
CareFirst Setting Professional Modifier None Typical Low $281.84 Median $309.03 Typical High $478.63 | Professional | None | $281.84 | $309.03 | $478.63 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $2,187.76 Typical High $4,365.16 | Facility | None | $478.63 | $2,187.76 | $4,365.16 |
Cigna Setting Professional Modifier None Typical Low $269.15 Median $407.38 Typical High $630.96 | Professional | None | $269.15 | $407.38 | $630.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $316.23 Median $467.74 Typical High $575.44 | Professional | None | $316.23 | $467.74 | $575.44 |
Medcost Setting Professional Modifier None Typical Low $562.34 Median $707.95 Typical High $707.95 | Professional | None | $562.34 | $707.95 | $707.95 |
Medcost Setting Facility Modifier None Typical Low $316.23 Median $524.81 Typical High $691.83 | Facility | None | $316.23 | $524.81 | $691.83 |
Medcost Setting Professional Modifier None Typical Low $371.54 Median $537.03 Typical High $537.03 | Professional | None | $371.54 | $537.03 | $537.03 |
Sentara Setting Facility Modifier None Typical Low $295.12 Median $660.69 Typical High $4,570.88 | Facility | None | $295.12 | $660.69 | $4,570.88 |
Sentara Setting Professional Modifier None Typical Low $398.11 Median $537.03 Typical High $1,698.24 | Professional | None | $398.11 | $537.03 | $1,698.24 |
United Setting Facility Modifier None Typical Low $323.59 Median $1,445.44 Typical High $15,848.93 | Facility | None | $323.59 | $1,445.44 | $15,848.93 |
United Setting Professional Modifier None Typical Low $251.19 Median $436.52 Typical High $707.95 | Professional | None | $251.19 | $436.52 | $707.95 |
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 $117.49 Median $169.82 Typical High $208.93 | Professional | 52 · Reduced service | $117.49 | $169.82 | $208.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $46.77 Median $67.61 Typical High $83.18 | Professional | 53 · Discontinued | $46.77 | $67.61 | $83.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $173.78 Median $251.19 Typical High $316.23 | Professional | 54 · Surgery only | $173.78 | $251.19 | $316.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $50.12 Typical High $63.10 | Professional | 55 · Aftercare only | $34.67 | $50.12 | $63.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $33.88 Typical High $41.69 | Professional | 56 · Pre-op care only | $23.44 | $33.88 | $41.69 |
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· 40th of 51
$407
AK $1,380NY $355
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.