How much rates vary
Facilitymedian $2,570 · 10th to 90th $347 to $9,550Professionalmedian $380 · 10th to 90th $295 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 $436.52 Median $3,801.89 Typical High $9,332.54 | Facility | None | $436.52 | $3,801.89 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $295.12 Median $436.52 Typical High $562.34 | Professional | None | $295.12 | $436.52 | $562.34 |
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 $316.23 Median $380.19 Typical High $446.68 | Professional | None | $316.23 | $380.19 | $446.68 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $478.63 Median $575.44 Typical High $676.08 | Professional | 50 · Both sides | $478.63 | $575.44 | $676.08 |
CareFirst Setting Professional Modifier None Typical Low $338.84 Median $371.54 Typical High $446.68 | Professional | None | $338.84 | $371.54 | $446.68 |
Cigna Setting Facility Modifier None Typical Low $302.00 Median $512.86 Typical High $2,691.53 | Facility | None | $302.00 | $512.86 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $309.03 Median $380.19 Typical High $512.86 | Professional | None | $309.03 | $380.19 | $512.86 |
Kaiser Permanente Setting Professional Modifier None Typical Low $426.58 Median $501.19 Typical High $630.96 | Professional | None | $426.58 | $501.19 | $630.96 |
Medcost Setting Professional Modifier None Typical Low $407.38 Median $478.63 Typical High $478.63 | Professional | None | $407.38 | $478.63 | $478.63 |
Medcost Setting Facility Modifier None Typical Low $295.12 Median $398.11 Typical High $724.44 | Facility | None | $295.12 | $398.11 | $724.44 |
Medcost Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $457.09 | Professional | None | $457.09 | $457.09 | $457.09 |
Sentara Setting Facility Modifier None Typical Low $251.19 Median $1,023.29 Typical High $8,709.64 | Facility | None | $251.19 | $1,023.29 | $8,709.64 |
Sentara Setting Professional Modifier None Typical Low $309.03 Median $478.63 Typical High $4,570.88 | Professional | None | $309.03 | $478.63 | $4,570.88 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $5,011.87 Typical High $13,182.57 | Facility | None | $1,230.27 | $5,011.87 | $13,182.57 |
United Setting Professional Modifier None Typical Low $257.04 Median $363.08 Typical High $630.96 | Professional | None | $257.04 | $363.08 | $630.96 |
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 $147.91 Median $213.80 Typical High $281.84 | Professional | 52 · Reduced service | $147.91 | $213.80 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $58.88 Median $87.10 Typical High $114.82 | Professional | 53 · Discontinued | $58.88 | $87.10 | $114.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $223.87 Median $323.59 Typical High $426.58 | Professional | 54 · Surgery only | $223.87 | $323.59 | $426.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $64.57 Typical High $85.11 | Professional | 55 · Aftercare only | $44.67 | $64.57 | $85.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $43.65 Typical High $56.23 | Professional | 56 · Pre-op care only | $29.51 | $43.65 | $56.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $208.93 Median $302.00 Typical High $398.11 | Professional | 78 · Unplanned return to OR | $208.93 | $302.00 | $398.11 |
Where Virginia sits
The same service costs 5.0 times more in Alaska than in Utah. 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· 39th of 51
$398
AK $1,380UT $275
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.