How much rates vary
Facilitymedian $1,660 · 10th to 90th $200 to $5,888Professionalmedian $200 · 10th to 90th $145 to $398
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 $239.88 Median $4,073.80 Typical High $9,332.54 | Facility | None | $239.88 | $4,073.80 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $134.90 Median $239.88 Typical High $489.78 | Professional | None | $134.90 | $239.88 | $489.78 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,884.03 Median $3,715.35 Typical High $4,265.80 | Facility | None | $2,884.03 | $3,715.35 | $4,265.80 |
Anthem BCBS Setting Professional Modifier None Typical Low $144.54 Median $177.83 Typical High $204.17 | Professional | None | $144.54 | $177.83 | $204.17 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $218.78 Median $263.03 Typical High $309.03 | Professional | 50 · Both sides | $218.78 | $263.03 | $309.03 |
CareFirst Setting Professional Modifier None Typical Low $144.54 Median $162.18 Typical High $190.55 | Professional | None | $144.54 | $162.18 | $190.55 |
Cigna Setting Facility Modifier None Typical Low $208.93 Median $389.05 Typical High $1,621.81 | Facility | None | $208.93 | $389.05 | $1,621.81 |
Cigna Setting Professional Modifier None Typical Low $141.25 Median $251.19 Typical High $363.08 | Professional | None | $141.25 | $251.19 | $363.08 |
Kaiser Permanente Setting Professional Modifier None Typical Low $269.15 Median $316.23 Typical High $398.11 | Professional | None | $269.15 | $316.23 | $398.11 |
Medcost Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $660.69 | Professional | None | $389.05 | $389.05 | $660.69 |
Medcost Setting Facility Modifier None Typical Low $134.90 Median $239.88 Typical High $501.19 | Facility | None | $134.90 | $239.88 | $501.19 |
Medcost Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $316.23 | Professional | None | $316.23 | $316.23 | $316.23 |
Sentara Setting Facility Modifier None Typical Low $138.04 Median $870.96 Typical High $3,630.78 | Facility | None | $138.04 | $870.96 | $3,630.78 |
Sentara Setting Professional Modifier None Typical Low $257.04 Median $346.74 Typical High $2,137.96 | Professional | None | $257.04 | $346.74 | $2,137.96 |
United Setting Facility Modifier None Typical Low $588.84 Median $2,187.76 Typical High $5,888.44 | Facility | None | $588.84 | $2,187.76 | $5,888.44 |
United Setting Professional Modifier None Typical Low $120.23 Median $218.78 Typical High $407.38 | Professional | None | $120.23 | $218.78 | $407.38 |
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 $67.61 Median $117.49 Typical High $186.21 | Professional | 52 · Reduced service | $67.61 | $117.49 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $46.77 Typical High $74.13 | Professional | 53 · Discontinued | $27.54 | $46.77 | $74.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $102.33 Median $177.83 Typical High $275.42 | Professional | 54 · Surgery only | $102.33 | $177.83 | $275.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.42 Median $35.48 Typical High $56.23 | Professional | 55 · Aftercare only | $20.42 | $35.48 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.49 Median $23.44 Typical High $37.15 | Professional | 56 · Pre-op care only | $13.49 | $23.44 | $37.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $95.50 Median $165.96 Typical High $257.04 | Professional | 78 · Unplanned return to OR | $95.50 | $165.96 | $257.04 |
Where Virginia sits
The same service costs 3.8 times more in Wyoming than in Kentucky. 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· 49th of 51
$214
WY $741KY $195
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.