How much rates vary
Facilitymedian $1,230 · 10th to 90th $288 to $7,762Professionalmedian $331 · 10th to 90th $257 to $741
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 $346.74 Median $5,623.41 Typical High $14,125.38 | Facility | None | $346.74 | $5,623.41 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $234.42 Median $346.74 Typical High $602.56 | Professional | None | $234.42 | $346.74 | $602.56 |
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 $257.04 Median $302.00 Typical High $363.08 | Professional | None | $257.04 | $302.00 | $363.08 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $380.19 Median $457.09 Typical High $537.03 | Professional | 50 · Both sides | $380.19 | $457.09 | $537.03 |
CareFirst Setting Professional Modifier None Typical Low $269.15 Median $302.00 Typical High $354.81 | Professional | None | $269.15 | $302.00 | $354.81 |
Cigna Setting Facility Modifier None Typical Low $181.97 Median $338.84 Typical High $1,621.81 | Facility | None | $181.97 | $338.84 | $1,621.81 |
Cigna Setting Professional Modifier None Typical Low $257.04 Median $354.81 Typical High $776.25 | Professional | None | $257.04 | $354.81 | $776.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $288.40 Median $338.84 Typical High $426.58 | Professional | None | $288.40 | $338.84 | $426.58 |
Medcost Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $1,148.15 | Professional | None | $831.76 | $831.76 | $1,148.15 |
Medcost Setting Facility Modifier None Typical Low $234.42 Median $537.03 Typical High $851.14 | Facility | None | $234.42 | $537.03 | $851.14 |
Medcost Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $831.76 | Professional | None | $831.76 | $831.76 | $831.76 |
Sentara Setting Facility Modifier None Typical Low $302.00 Median $707.95 Typical High $2,951.21 | Facility | None | $302.00 | $707.95 | $2,951.21 |
Sentara Setting Professional Modifier None Typical Low $338.84 Median $660.69 Typical High $1,737.80 | Professional | None | $338.84 | $660.69 | $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 $223.87 Median $457.09 Typical High $831.76 | Professional | None | $223.87 | $457.09 | $831.76 |
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 $117.49 Median $173.78 Typical High $190.55 | Professional | 52 · Reduced service | $117.49 | $173.78 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $69.18 Typical High $75.86 | Professional | 53 · Discontinued | $47.86 | $69.18 | $75.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $263.03 Typical High $281.84 | Professional | 54 · Surgery only | $177.83 | $263.03 | $281.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $52.48 Typical High $57.54 | Professional | 55 · Aftercare only | $35.48 | $52.48 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $34.67 Typical High $38.02 | Professional | 56 · Pre-op care only | $23.44 | $34.67 | $38.02 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $165.96 Median $245.47 Typical High $263.03 | Professional | 78 · Unplanned return to OR | $165.96 | $245.47 | $263.03 |
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· 43rd of 51
$347
AK $1,096UT $219
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.