How much rates vary
Facilitymedian $5,495 · 10th to 90th $513 to $13,490Professionalmedian $562 · 10th to 90th $389 to $2,951
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 $562.34 Median $5,495.41 Typical High $10,964.78 | Facility | None | $562.34 | $5,495.41 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $380.19 Median $2,089.30 Typical High $2,951.21 | Professional | None | $380.19 | $2,089.30 | $2,951.21 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,165.95 Median $7,413.10 Typical High $9,549.93 | Facility | None | $6,165.95 | $7,413.10 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $416.87 Median $501.19 Typical High $575.44 | Professional | None | $416.87 | $501.19 | $575.44 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $616.60 Median $741.31 Typical High $870.96 | Professional | 50 · Both sides | $616.60 | $741.31 | $870.96 |
CareFirst Setting Professional Modifier None Typical Low $436.52 Median $489.78 Typical High $575.44 | Professional | None | $436.52 | $489.78 | $575.44 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $3,388.44 Typical High $6,760.83 | Facility | None | $512.86 | $3,388.44 | $6,760.83 |
Cigna Setting Professional Modifier None Typical Low $346.74 Median $1,659.59 Typical High $2,884.03 | Professional | None | $346.74 | $1,659.59 | $2,884.03 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,089.30 Median $2,454.71 Typical High $3,019.95 | Professional | None | $2,089.30 | $2,454.71 | $3,019.95 |
Medcost Setting Facility Modifier None Typical Low $380.19 Median $812.83 Typical High $4,466.84 | Facility | None | $380.19 | $812.83 | $4,466.84 |
Medcost Setting Professional Modifier None Typical Low $2,818.38 Median $2,818.38 Typical High $2,818.38 | Professional | None | $2,818.38 | $2,818.38 | $2,818.38 |
Sentara Setting Facility Modifier None Typical Low $389.05 Median $1,949.84 Typical High $10,232.93 | Facility | None | $389.05 | $1,949.84 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $2,137.96 Median $2,630.27 Typical High $9,549.93 | Professional | None | $2,137.96 | $2,630.27 | $9,549.93 |
United Setting Facility Modifier None Typical Low $1,995.26 Median $8,511.38 Typical High $20,417.38 | Facility | None | $1,995.26 | $8,511.38 | $20,417.38 |
United Setting Professional Modifier None Typical Low $354.81 Median $1,096.48 Typical High $3,388.44 | Professional | None | $354.81 | $1,096.48 | $3,388.44 |
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 $190.55 Median $870.96 Typical High $1,445.44 | Professional | 52 · Reduced service | $190.55 | $870.96 | $1,445.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $346.74 Typical High $588.84 | Professional | 53 · Discontinued | $75.86 | $346.74 | $588.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $288.40 Median $1,288.25 Typical High $2,187.76 | Professional | 54 · Surgery only | $288.40 | $1,288.25 | $2,187.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $263.03 Typical High $436.52 | Professional | 55 · Aftercare only | $57.54 | $263.03 | $436.52 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $173.78 Typical High $295.12 | Professional | 56 · Pre-op care only | $38.02 | $173.78 | $295.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $269.15 Median $1,202.26 Typical High $2,041.74 | Professional | 78 · Unplanned return to OR | $269.15 | $1,202.26 | $2,041.74 |
Where Virginia sits
The same service costs 9.8 times more in Alaska than in Kentucky. 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· 50th of 51
$575
AK $4,898KY $501
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.