How much rates vary
Facilitymedian $3,090 · 10th to 90th $550 to $10,000Professionalmedian $513 · 10th to 90th $389 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 $562.34 Median $5,495.41 Typical High $10,964.78 | Facility | None | $562.34 | $5,495.41 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $380.19 Median $562.34 Typical High $707.95 | Professional | None | $380.19 | $562.34 | $707.95 |
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 $407.38 Median $489.78 Typical High $575.44 | Professional | None | $407.38 | $489.78 | $575.44 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $602.56 Median $724.44 Typical High $851.14 | Professional | 50 · Both sides | $602.56 | $724.44 | $851.14 |
CareFirst Setting Professional Modifier None Typical Low $407.38 Median $457.09 Typical High $537.03 | Professional | None | $407.38 | $457.09 | $537.03 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $1,288.25 Typical High $2,951.21 | Facility | None | $645.65 | $1,288.25 | $2,951.21 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $512.86 Typical High $691.83 | Professional | None | $389.05 | $512.86 | $691.83 |
Kaiser Permanente Setting Professional Modifier None Typical Low $537.03 Median $630.96 Typical High $794.33 | Professional | None | $537.03 | $630.96 | $794.33 |
Medcost Setting Professional Modifier None Typical Low $776.25 Median $794.33 Typical High $794.33 | Professional | None | $776.25 | $794.33 | $794.33 |
Medcost Setting Facility Modifier None Typical Low $380.19 Median $524.81 Typical High $977.24 | Facility | None | $380.19 | $524.81 | $977.24 |
Medcost Setting Professional Modifier None Typical Low $630.96 Median $630.96 Typical High $630.96 | Professional | None | $630.96 | $630.96 | $630.96 |
Sentara Setting Facility Modifier None Typical Low $389.05 Median $1,174.90 Typical High $8,709.64 | Facility | None | $389.05 | $1,174.90 | $8,709.64 |
Sentara Setting Professional Modifier None Typical Low $549.54 Median $645.65 Typical High $5,128.61 | Professional | None | $549.54 | $645.65 | $5,128.61 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $5,011.87 Typical High $13,182.57 | Facility | None | $1,230.27 | $5,011.87 | $13,182.57 |
United Setting Professional Modifier None Typical Low $331.13 Median $489.78 Typical High $870.96 | Professional | None | $331.13 | $489.78 | $870.96 |
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 $190.55 Median $275.42 Typical High $354.81 | Professional | 52 · Reduced service | $190.55 | $275.42 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $112.20 Typical High $144.54 | Professional | 53 · Discontinued | $75.86 | $112.20 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $281.84 Median $416.87 Typical High $537.03 | Professional | 54 · Surgery only | $281.84 | $416.87 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $83.18 Typical High $107.15 | Professional | 55 · Aftercare only | $56.23 | $83.18 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $56.23 Typical High $70.79 | Professional | 56 · Pre-op care only | $38.02 | $56.23 | $70.79 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $263.03 Median $389.05 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $263.03 | $389.05 | $501.19 |
Where Virginia sits
The same service costs 6.5 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· 41st of 51
$525
AK $2,239UT $347
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.