How much rates vary
Facilitymedian $2,692 · 10th to 90th $251 to $9,550Professionalmedian $251 · 10th to 90th $186 to $457
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 $257.04 Median $5,248.07 Typical High $10,000.00 | Facility | None | $257.04 | $5,248.07 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $169.82 Median $257.04 Typical High $416.87 | Professional | None | $169.82 | $257.04 | $416.87 |
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 $186.21 Median $229.09 Typical High $263.03 | Professional | None | $186.21 | $229.09 | $263.03 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $281.84 Median $331.13 Typical High $398.11 | Professional | 50 · Both sides | $281.84 | $331.13 | $398.11 |
CareFirst Setting Professional Modifier None Typical Low $199.53 Median $218.78 Typical High $257.04 | Professional | None | $199.53 | $218.78 | $257.04 |
Cigna Setting Facility Modifier None Typical Low $251.19 Median $416.87 Typical High $1,621.81 | Facility | None | $251.19 | $416.87 | $1,621.81 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $281.84 Typical High $446.68 | Professional | None | $177.83 | $281.84 | $446.68 |
Kaiser Permanente Setting Professional Modifier None Typical Low $309.03 Median $363.08 Typical High $457.09 | Professional | None | $309.03 | $363.08 | $457.09 |
Medcost Setting Professional Modifier None Typical Low $588.84 Median $588.84 Typical High $602.56 | Professional | None | $588.84 | $588.84 | $602.56 |
Medcost Setting Facility Modifier None Typical Low $169.82 Median $309.03 Typical High $549.54 | Facility | None | $169.82 | $309.03 | $549.54 |
Medcost Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $407.38 | Professional | None | $407.38 | $407.38 | $407.38 |
Sentara Setting Facility Modifier None Typical Low $204.17 Median $912.01 Typical High $8,709.64 | Facility | None | $204.17 | $912.01 | $8,709.64 |
Sentara Setting Professional Modifier None Typical Low $309.03 Median $457.09 Typical High $4,570.88 | Professional | None | $309.03 | $457.09 | $4,570.88 |
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 $169.82 Median $275.42 Typical High $478.63 | Professional | None | $169.82 | $275.42 | $478.63 |
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 $85.11 Median $128.82 Typical High $208.93 | Professional | 52 · Reduced service | $85.11 | $128.82 | $208.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $51.29 Typical High $83.18 | Professional | 53 · Discontinued | $33.88 | $51.29 | $83.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $194.98 Typical High $316.23 | Professional | 54 · Surgery only | $128.82 | $194.98 | $316.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $38.90 Typical High $63.10 | Professional | 55 · Aftercare only | $25.70 | $38.90 | $63.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $25.70 Typical High $41.69 | Professional | 56 · Pre-op care only | $16.98 | $25.70 | $41.69 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $120.23 Median $181.97 Typical High $295.12 | Professional | 78 · Unplanned return to OR | $120.23 | $181.97 | $295.12 |
Where Virginia sits
The same service costs 4.3 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· 47th of 51
$257
WY $933UT $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.