How much rates vary
Facilitymedian $1,175 · 10th to 90th $257 to $5,623Professionalmedian $288 · 10th to 90th $224 to $437
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 $269.15 Median $5,495.41 Typical High $10,964.78 | Facility | None | $269.15 | $5,495.41 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $218.78 Median $309.03 Typical High $398.11 | Professional | None | $218.78 | $309.03 | $398.11 |
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 $229.09 Median $275.42 Typical High $323.59 | Professional | None | $229.09 | $275.42 | $323.59 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $346.74 Median $416.87 Typical High $489.78 | Professional | 50 · Both sides | $346.74 | $416.87 | $489.78 |
CareFirst Setting Professional Modifier None Typical Low $239.88 Median $269.15 Typical High $316.23 | Professional | None | $239.88 | $269.15 | $316.23 |
Cigna Setting Facility Modifier None Typical Low $186.21 Median $354.81 Typical High $1,621.81 | Facility | None | $186.21 | $354.81 | $1,621.81 |
Cigna Setting Professional Modifier None Typical Low $223.87 Median $288.40 Typical High $407.38 | Professional | None | $223.87 | $288.40 | $407.38 |
Kaiser Permanente Setting Professional Modifier None Typical Low $295.12 Median $346.74 Typical High $436.52 | Professional | None | $295.12 | $346.74 | $436.52 |
Medcost Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $512.86 | Professional | None | $398.11 | $398.11 | $512.86 |
Medcost Setting Facility Modifier None Typical Low $218.78 Median $309.03 Typical High $562.34 | Facility | None | $218.78 | $309.03 | $562.34 |
Medcost Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $380.19 | Professional | None | $380.19 | $380.19 | $380.19 |
Sentara Setting Facility Modifier None Typical Low $229.09 Median $630.96 Typical High $2,951.21 | Facility | None | $229.09 | $630.96 | $2,951.21 |
Sentara Setting Professional Modifier None Typical Low $302.00 Median $371.54 Typical High $1,737.80 | Professional | None | $302.00 | $371.54 | $1,737.80 |
United Setting Facility Modifier None Typical Low $323.59 Median $1,412.54 Typical High $3,630.78 | Facility | None | $323.59 | $1,412.54 | $3,630.78 |
United Setting Professional Modifier None Typical Low $190.55 Median $281.84 Typical High $489.78 | Professional | None | $190.55 | $281.84 | $489.78 |
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 $109.65 Median $154.88 Typical High $194.98 | Professional | 52 · Reduced service | $109.65 | $154.88 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $61.66 Typical High $79.43 | Professional | 53 · Discontinued | $43.65 | $61.66 | $79.43 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $162.18 Median $234.42 Typical High $295.12 | Professional | 54 · Surgery only | $162.18 | $234.42 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $32.36 Median $46.77 Typical High $58.88 | Professional | 55 · Aftercare only | $32.36 | $46.77 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $30.90 Typical High $39.81 | Professional | 56 · Pre-op care only | $21.88 | $30.90 | $39.81 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $151.36 Median $218.78 Typical High $275.42 | Professional | 78 · Unplanned return to OR | $151.36 | $218.78 | $275.42 |
Where Virginia sits
The same service costs 5.2 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· 41st of 51
$295
AK $1,000UT $191
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.