How much rates vary
Facilitymedian $550 · 10th to 90th $110 to $3,981Professionalmedian $141 · 10th to 90th $110 to $229
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 $131.83 Median $3,801.89 Typical High $9,332.54 | Facility | None | $131.83 | $3,801.89 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $123.03 Median $147.91 Typical High $257.04 | Professional | None | $123.03 | $147.91 | $257.04 |
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 $112.20 Median $134.90 Typical High $162.18 | Professional | None | $112.20 | $134.90 | $162.18 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $169.82 Median $199.53 Typical High $245.47 | Professional | 50 · Both sides | $169.82 | $199.53 | $245.47 |
CareFirst Setting Professional Modifier None Typical Low $123.03 Median $134.90 Typical High $177.83 | Professional | None | $123.03 | $134.90 | $177.83 |
Cigna Setting Facility Modifier None Typical Low $87.10 Median $234.42 Typical High $1,621.81 | Facility | None | $87.10 | $234.42 | $1,621.81 |
Cigna Setting Professional Modifier None Typical Low $114.82 Median $138.04 Typical High $218.78 | Professional | None | $114.82 | $138.04 | $218.78 |
Kaiser Permanente Setting Professional Modifier None Typical Low $138.04 Median $165.96 Typical High $208.93 | Professional | None | $138.04 | $165.96 | $208.93 |
Medcost Setting Professional Modifier None Typical Low $218.78 Median $275.42 Typical High $275.42 | Professional | None | $218.78 | $275.42 | $275.42 |
Medcost Setting Facility Modifier None Typical Low $131.83 Median $177.83 Typical High $245.47 | Facility | None | $131.83 | $177.83 | $245.47 |
Medcost Setting Professional Modifier None Typical Low $144.54 Median $204.17 Typical High $204.17 | Professional | None | $144.54 | $204.17 | $204.17 |
Sentara Setting Facility Modifier None Typical Low $123.03 Median $371.54 Typical High $2,454.71 | Facility | None | $123.03 | $371.54 | $2,454.71 |
Sentara Setting Professional Modifier None Typical Low $138.04 Median $194.98 Typical High $346.74 | Professional | None | $138.04 | $194.98 | $346.74 |
United Setting Facility Modifier None Typical Low $100.00 Median $660.69 Typical High $2,041.74 | Facility | None | $100.00 | $660.69 | $2,041.74 |
United Setting Professional Modifier None Typical Low $85.11 Median $128.82 Typical High $245.47 | Professional | None | $85.11 | $128.82 | $245.47 |
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 $61.66 Median $69.18 Typical High $74.13 | Professional | 52 · Reduced service | $61.66 | $69.18 | $74.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $27.54 Typical High $30.20 | Professional | 53 · Discontinued | $24.55 | $27.54 | $30.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $93.33 Median $102.33 Typical High $112.20 | Professional | 54 · Surgery only | $93.33 | $102.33 | $112.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $20.42 Typical High $22.39 | Professional | 55 · Aftercare only | $18.62 | $20.42 | $22.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $13.80 Typical High $14.79 | Professional | 56 · Pre-op care only | $12.30 | $13.80 | $14.79 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $87.10 Median $95.50 Typical High $104.71 | Professional | 78 · Unplanned return to OR | $87.10 | $95.50 | $104.71 |
Where Virginia sits
The same service costs 4.2 times more in Alaska than in Florida. 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· 41st of 51
$141
AK $490FL $117
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.