How much rates vary
Facilitymedian $2,754 · 10th to 90th $398 to $9,550Professionalmedian $380 · 10th to 90th $275 to $631
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 $398.11 Median $5,248.07 Typical High $10,000.00 | Facility | None | $398.11 | $5,248.07 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $269.15 Median $398.11 Typical High $645.65 | Professional | None | $269.15 | $398.11 | $645.65 |
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 $288.40 Median $354.81 Typical High $407.38 | Professional | None | $288.40 | $354.81 | $407.38 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $436.52 Median $524.81 Typical High $616.60 | Professional | 50 · Both sides | $436.52 | $524.81 | $616.60 |
CareFirst Setting Professional Modifier None Typical Low $295.12 Median $331.13 Typical High $389.05 | Professional | None | $295.12 | $331.13 | $389.05 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $1,230.27 Typical High $2,570.40 | Facility | None | $524.81 | $1,230.27 | $2,570.40 |
Cigna Setting Professional Modifier None Typical Low $275.42 Median $416.87 Typical High $549.54 | Professional | None | $275.42 | $416.87 | $549.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $467.74 Median $549.54 Typical High $691.83 | Professional | None | $467.74 | $549.54 | $691.83 |
Medcost Setting Professional Modifier None Typical Low $478.63 Median $660.69 Typical High $660.69 | Professional | None | $478.63 | $660.69 | $660.69 |
Medcost Setting Facility Modifier None Typical Low $269.15 Median $398.11 Typical High $851.14 | Facility | None | $269.15 | $398.11 | $851.14 |
Medcost Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $436.52 | Professional | None | $436.52 | $436.52 | $436.52 |
Sentara Setting Facility Modifier None Typical Low $245.47 Median $1,148.15 Typical High $8,709.64 | Facility | None | $245.47 | $1,148.15 | $8,709.64 |
Sentara Setting Professional Modifier None Typical Low $426.58 Median $549.54 Typical High $4,570.88 | Professional | None | $426.58 | $549.54 | $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 $223.87 Median $363.08 Typical High $676.08 | Professional | None | $223.87 | $363.08 | $676.08 |
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 $134.90 Median $199.53 Typical High $316.23 | Professional | 52 · Reduced service | $134.90 | $199.53 | $316.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $81.28 Typical High $125.89 | Professional | 53 · Discontinued | $53.70 | $81.28 | $125.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $199.53 Median $302.00 Typical High $478.63 | Professional | 54 · Surgery only | $199.53 | $302.00 | $478.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $60.26 Typical High $95.50 | Professional | 55 · Aftercare only | $39.81 | $60.26 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $39.81 Typical High $63.10 | Professional | 56 · Pre-op care only | $26.92 | $39.81 | $63.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $186.21 Median $281.84 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $186.21 | $281.84 | $446.68 |
Where Virginia sits
The same service costs 5.9 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· 43rd of 51
$398
AK $1,698UT $288
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.