How much rates vary
Facilitymedian $550 · 10th to 90th $93 to $3,981Professionalmedian $110 · 10th to 90th $85 to $224
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 $114.82 Median $3,801.89 Typical High $9,332.54 | Facility | None | $114.82 | $3,801.89 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $85.11 Median $114.82 Typical High $239.88 | Professional | None | $85.11 | $114.82 | $239.88 |
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 $85.11 Median $102.33 Typical High $120.23 | Professional | None | $85.11 | $102.33 | $120.23 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $125.89 Median $151.36 Typical High $177.83 | Professional | 50 · Both sides | $125.89 | $151.36 | $177.83 |
CareFirst Setting Professional Modifier None Typical Low $89.13 Median $100.00 Typical High $123.03 | Professional | None | $89.13 | $100.00 | $123.03 |
Cigna Setting Facility Modifier None Typical Low $64.57 Median $173.78 Typical High $1,621.81 | Facility | None | $64.57 | $173.78 | $1,621.81 |
Cigna Setting Professional Modifier None Typical Low $85.11 Median $104.71 Typical High $199.53 | Professional | None | $85.11 | $104.71 | $199.53 |
Kaiser Permanente Setting Professional Modifier None Typical Low $109.65 Median $128.82 Typical High $162.18 | Professional | None | $109.65 | $128.82 | $162.18 |
Medcost Setting Professional Modifier None Typical Low $389.05 Median $478.63 Typical High $478.63 | Professional | None | $389.05 | $478.63 | $478.63 |
Medcost Setting Facility Modifier None Typical Low $85.11 Median $186.21 Typical High $257.04 | Facility | None | $85.11 | $186.21 | $257.04 |
Medcost Setting Professional Modifier None Typical Low $251.19 Median $251.19 Typical High $251.19 | Professional | None | $251.19 | $251.19 | $251.19 |
Sentara Setting Facility Modifier None Typical Low $100.00 Median $380.19 Typical High $2,454.71 | Facility | None | $100.00 | $380.19 | $2,454.71 |
Sentara Setting Professional Modifier None Typical Low $112.20 Median $194.98 Typical High $870.96 | Professional | None | $112.20 | $194.98 | $870.96 |
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 $75.86 Median $138.04 Typical High $239.88 | Professional | None | $75.86 | $138.04 | $239.88 |
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 $42.66 Median $57.54 Typical High $72.44 | Professional | 52 · Reduced service | $42.66 | $57.54 | $72.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $22.91 Typical High $28.84 | Professional | 53 · Discontinued | $16.98 | $22.91 | $28.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $64.57 Median $85.11 Typical High $107.15 | Professional | 54 · Surgery only | $64.57 | $85.11 | $107.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $16.98 Typical High $21.88 | Professional | 55 · Aftercare only | $12.88 | $16.98 | $21.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $11.48 Typical High $14.45 | Professional | 56 · Pre-op care only | $8.51 | $11.48 | $14.45 |
Where Virginia sits
The same service costs 3.7 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· 44th of 51
$115
AK $363FL $97.72
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.