How much rates vary
Facilitymedian $617 · 10th to 90th $155 to $3,981Professionalmedian $240 · 10th to 90th $186 to $355
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 $208.93 Median $4,073.80 Typical High $10,000.00 | Facility | None | $208.93 | $4,073.80 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $186.21 Median $275.42 Typical High $371.54 | Professional | None | $186.21 | $275.42 | $371.54 |
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 $199.53 Median $239.88 Typical High $281.84 | Professional | None | $199.53 | $239.88 | $281.84 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $302.00 Median $363.08 Typical High $426.58 | Professional | 50 · Both sides | $302.00 | $363.08 | $426.58 |
CareFirst Setting Professional Modifier None Typical Low $213.80 Median $239.88 Typical High $281.84 | Professional | None | $213.80 | $239.88 | $281.84 |
Cigna Setting Facility Modifier None Typical Low $138.04 Median $316.23 Typical High $1,621.81 | Facility | None | $138.04 | $316.23 | $1,621.81 |
Cigna Setting Professional Modifier None Typical Low $194.98 Median $229.09 Typical High $323.59 | Professional | None | $194.98 | $229.09 | $323.59 |
Kaiser Permanente Setting Professional Modifier None Typical Low $239.88 Median $281.84 Typical High $354.81 | Professional | None | $239.88 | $281.84 | $354.81 |
Medcost Setting Professional Modifier None Typical Low $354.81 Median $389.05 Typical High $389.05 | Professional | None | $354.81 | $389.05 | $389.05 |
Medcost Setting Facility Modifier None Typical Low $186.21 Median $257.04 Typical High $446.68 | Facility | None | $186.21 | $257.04 | $446.68 |
Medcost Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $281.84 | Professional | None | $281.84 | $281.84 | $281.84 |
Sentara Setting Facility Modifier None Typical Low $186.21 Median $426.58 Typical High $2,454.71 | Facility | None | $186.21 | $426.58 | $2,454.71 |
Sentara Setting Professional Modifier None Typical Low $245.47 Median $288.40 Typical High $1,122.02 | Professional | None | $245.47 | $288.40 | $1,122.02 |
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 $162.18 Median $229.09 Typical High $389.05 | Professional | None | $162.18 | $229.09 | $389.05 |
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 $93.33 Median $134.90 Typical High $154.88 | Professional | 52 · Reduced service | $93.33 | $134.90 | $154.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $54.95 Typical High $61.66 | Professional | 53 · Discontinued | $38.02 | $54.95 | $61.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $204.17 Typical High $234.42 | Professional | 54 · Surgery only | $141.25 | $204.17 | $234.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $40.74 Typical High $46.77 | Professional | 55 · Aftercare only | $28.18 | $40.74 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $27.54 Typical High $30.90 | Professional | 56 · Pre-op care only | $18.62 | $27.54 | $30.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $131.83 Median $190.55 Typical High $218.78 | Professional | 78 · Unplanned return to OR | $131.83 | $190.55 | $218.78 |
Where Virginia sits
The same service costs 4.3 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· 40th of 51
$245
AK $871FL $204
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.