How much rates vary
Facilitymedian $4,266 · 10th to 90th $631 to $11,220Professionalmedian $550 · 10th to 90th $437 to $759
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 $630.96 Median $6,165.95 Typical High $11,481.54 | Facility | None | $630.96 | $6,165.95 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $436.52 Median $630.96 Typical High $4,168.69 | Professional | None | $436.52 | $630.96 | $4,168.69 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,677.35 Median $6,456.54 Typical High $7,244.36 | Facility | None | $4,677.35 | $6,456.54 | $7,244.36 |
Anthem BCBS Setting Professional Modifier None Typical Low $467.74 Median $562.34 Typical High $660.69 | Professional | None | $467.74 | $562.34 | $660.69 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $707.95 Median $831.76 Typical High $1,000.00 | Professional | 50 · Both sides | $707.95 | $831.76 | $1,000.00 |
CareFirst Setting Professional Modifier None Typical Low $467.74 Median $524.81 Typical High $616.60 | Professional | None | $467.74 | $524.81 | $616.60 |
Cigna Setting Facility Modifier None Typical Low $724.44 Median $1,819.70 Typical High $3,467.37 | Facility | None | $724.44 | $1,819.70 | $3,467.37 |
Cigna Setting Professional Modifier None Typical Low $446.68 Median $489.78 Typical High $707.95 | Professional | None | $446.68 | $489.78 | $707.95 |
Kaiser Permanente Setting Professional Modifier None Typical Low $416.87 Median $478.63 Typical High $588.84 | Professional | None | $416.87 | $478.63 | $588.84 |
Medcost Setting Professional Modifier None Typical Low $831.76 Median $851.14 Typical High $851.14 | Professional | None | $831.76 | $851.14 | $851.14 |
Medcost Setting Facility Modifier None Typical Low $436.52 Median $616.60 Typical High $933.25 | Facility | None | $436.52 | $616.60 | $933.25 |
Medcost Setting Professional Modifier None Typical Low $588.84 Median $588.84 Typical High $588.84 | Professional | None | $588.84 | $588.84 | $588.84 |
Sentara Setting Facility Modifier None Typical Low $446.68 Median $1,348.96 Typical High $10,232.93 | Facility | None | $446.68 | $1,348.96 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $501.19 Median $616.60 Typical High $6,456.54 | Professional | None | $501.19 | $616.60 | $6,456.54 |
United Setting Facility Modifier None Typical Low $1,548.82 Median $6,760.83 Typical High $17,378.01 | Facility | None | $1,548.82 | $6,760.83 | $17,378.01 |
United Setting Professional Modifier None Typical Low $371.54 Median $524.81 Typical High $831.76 | Professional | None | $371.54 | $524.81 | $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 $218.78 Median $316.23 Typical High $316.23 | Professional | 52 · Reduced service | $218.78 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $87.10 Median $128.82 Typical High $128.82 | Professional | 53 · Discontinued | $87.10 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $478.63 Typical High $478.63 | Professional | 54 · Surgery only | $331.13 | $478.63 | $478.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $95.50 Typical High $95.50 | Professional | 55 · Aftercare only | $66.07 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $63.10 Typical High $63.10 | Professional | 56 · Pre-op care only | $43.65 | $63.10 | $63.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $309.03 Median $446.68 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $309.03 | $446.68 | $446.68 |
Where Virginia sits
The same service costs 7.9 times more in Wyoming 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· 37th of 51
$589
WY $2,399UT $302
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.