How much rates vary
Facilitymedian $1,230 · 10th to 90th $316 to $4,898Professionalmedian $380 · 10th to 90th $309 to $575
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 $446.68 Median $4,073.80 Typical High $9,332.54 | Facility | None | $446.68 | $4,073.80 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $309.03 Median $446.68 Typical High $691.83 | Professional | None | $309.03 | $446.68 | $691.83 |
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 $331.13 Median $389.05 Typical High $467.74 | Professional | None | $331.13 | $389.05 | $467.74 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $489.78 Median $588.84 Typical High $691.83 | Professional | 50 · Both sides | $489.78 | $588.84 | $691.83 |
CareFirst Setting Professional Modifier None Typical Low $331.13 Median $363.08 Typical High $426.58 | Professional | None | $331.13 | $363.08 | $426.58 |
Cigna Setting Facility Modifier None Typical Low $309.03 Median $549.54 Typical High $2,187.76 | Facility | None | $309.03 | $549.54 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $363.08 Typical High $512.86 | Professional | None | $316.23 | $363.08 | $512.86 |
Kaiser Permanente Setting Professional Modifier None Typical Low $371.54 Median $436.52 Typical High $549.54 | Professional | None | $371.54 | $436.52 | $549.54 |
Medcost Setting Professional Modifier None Typical Low $446.68 Median $446.68 Typical High $549.54 | Professional | None | $446.68 | $446.68 | $549.54 |
Medcost Setting Facility Modifier None Typical Low $309.03 Median $416.87 Typical High $707.95 | Facility | None | $309.03 | $416.87 | $707.95 |
Medcost Setting Professional Modifier None Typical Low $446.68 Median $446.68 Typical High $446.68 | Professional | None | $446.68 | $446.68 | $446.68 |
Sentara Setting Facility Modifier None Typical Low $275.42 Median $676.08 Typical High $2,951.21 | Facility | None | $275.42 | $676.08 | $2,951.21 |
Sentara Setting Professional Modifier None Typical Low $309.03 Median $446.68 Typical High $1,778.28 | Professional | None | $309.03 | $446.68 | $1,778.28 |
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 $257.04 Median $354.81 Typical High $616.60 | Professional | None | $257.04 | $354.81 | $616.60 |
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 $154.88 Median $223.87 Typical High $251.19 | Professional | 52 · Reduced service | $154.88 | $223.87 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $89.13 Typical High $100.00 | Professional | 53 · Discontinued | $61.66 | $89.13 | $100.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $229.09 Median $338.84 Typical High $371.54 | Professional | 54 · Surgery only | $229.09 | $338.84 | $371.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $67.61 Typical High $74.13 | Professional | 55 · Aftercare only | $45.71 | $67.61 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $44.67 Typical High $50.12 | Professional | 56 · Pre-op care only | $30.90 | $44.67 | $50.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $213.80 Median $316.23 Typical High $346.74 | Professional | 78 · Unplanned return to OR | $213.80 | $316.23 | $346.74 |
Where Virginia sits
The same service costs 5.6 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· 38th of 51
$398
AK $1,413UT $251
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.