How much rates vary
Facilitymedian $2,951 · 10th to 90th $676 to $9,550Professionalmedian $724 · 10th to 90th $562 to $1,096
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 $660.69 Median $5,248.07 Typical High $10,000.00 | Facility | None | $660.69 | $5,248.07 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $562.34 Median $831.76 Typical High $1,071.52 | Professional | None | $562.34 | $831.76 | $1,071.52 |
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 $602.56 Median $724.44 Typical High $851.14 | Professional | None | $602.56 | $724.44 | $851.14 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $912.01 Median $1,096.48 Typical High $1,288.25 | Professional | 50 · Both sides | $912.01 | $1,096.48 | $1,288.25 |
CareFirst Setting Professional Modifier None Typical Low $602.56 Median $676.08 Typical High $794.33 | Professional | None | $602.56 | $676.08 | $794.33 |
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 $588.84 Median $724.44 Typical High $1,000.00 | Professional | None | $588.84 | $724.44 | $1,000.00 |
Kaiser Permanente Setting Professional Modifier None Typical Low $758.58 Median $891.25 Typical High $1,096.48 | Professional | None | $758.58 | $891.25 | $1,096.48 |
Medcost Setting Professional Modifier None Typical Low $794.33 Median $794.33 Typical High $954.99 | Professional | None | $794.33 | $794.33 | $954.99 |
Medcost Setting Facility Modifier None Typical Low $562.34 Median $776.25 Typical High $1,412.54 | Facility | None | $562.34 | $776.25 | $1,412.54 |
Medcost Setting Professional Modifier None Typical Low $912.01 Median $912.01 Typical High $912.01 | Professional | None | $912.01 | $912.01 | $912.01 |
Sentara Setting Facility Modifier None Typical Low $489.78 Median $1,698.24 Typical High $8,709.64 | Facility | None | $489.78 | $1,698.24 | $8,709.64 |
Sentara Setting Professional Modifier None Typical Low $575.44 Median $891.25 Typical High $4,570.88 | Professional | None | $575.44 | $891.25 | $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 $489.78 Median $660.69 Typical High $1,230.27 | Professional | None | $489.78 | $660.69 | $1,230.27 |
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 $281.84 Median $416.87 Typical High $501.19 | Professional | 52 · Reduced service | $281.84 | $416.87 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $165.96 Typical High $199.53 | Professional | 53 · Discontinued | $112.20 | $165.96 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $616.60 Typical High $758.58 | Professional | 54 · Surgery only | $426.58 | $616.60 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $123.03 Typical High $151.36 | Professional | 55 · Aftercare only | $85.11 | $123.03 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $83.18 Typical High $100.00 | Professional | 56 · Pre-op care only | $56.23 | $83.18 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $575.44 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $398.11 | $575.44 | $707.95 |
Where Virginia sits
The same service costs 3.7 times more in Alaska than in West Virginia. 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.
Physician feeFacility fee
AK $6,098WV $1,627
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.