How much rates vary
Facilitymedian $2,570 · 10th to 90th $141 to $9,550Professionalmedian $166 · 10th to 90th $129 to $245
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 $134.90 Median $4,073.80 Typical High $10,000.00 | Facility | None | $134.90 | $4,073.80 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $128.82 Median $190.55 Typical High $223.87 | Professional | None | $128.82 | $190.55 | $223.87 |
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 $138.04 Median $165.96 Typical High $194.98 | Professional | None | $138.04 | $165.96 | $194.98 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $208.93 Median $251.19 Typical High $295.12 | Professional | 50 · Both sides | $208.93 | $251.19 | $295.12 |
CareFirst Setting Professional Modifier None Typical Low $147.91 Median $165.96 Typical High $194.98 | Professional | None | $147.91 | $165.96 | $194.98 |
Cigna Setting Facility Modifier None Typical Low $95.50 Median $257.04 Typical High $1,621.81 | Facility | None | $95.50 | $257.04 | $1,621.81 |
Cigna Setting Professional Modifier None Typical Low $134.90 Median $151.36 Typical High $218.78 | Professional | None | $134.90 | $151.36 | $218.78 |
Kaiser Permanente Setting Professional Modifier None Typical Low $154.88 Median $181.97 Typical High $223.87 | Professional | None | $154.88 | $181.97 | $223.87 |
Medcost Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $389.05 | Professional | None | $380.19 | $380.19 | $389.05 |
Medcost Setting Facility Modifier None Typical Low $128.82 Median $181.97 Typical High $288.40 | Facility | None | $128.82 | $181.97 | $288.40 |
Medcost Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $181.97 | Professional | None | $181.97 | $181.97 | $181.97 |
Sentara Setting Facility Modifier None Typical Low $128.82 Median $851.14 Typical High $8,709.64 | Facility | None | $128.82 | $851.14 | $8,709.64 |
Sentara Setting Professional Modifier None Typical Low $158.49 Median $229.09 Typical High $4,570.88 | Professional | None | $158.49 | $229.09 | $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 $109.65 Median $151.36 Typical High $257.04 | Professional | None | $109.65 | $151.36 | $257.04 |
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 $64.57 Median $95.50 Typical High $102.33 | Professional | 52 · Reduced service | $64.57 | $95.50 | $102.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $38.02 Typical High $40.74 | Professional | 53 · Discontinued | $25.70 | $38.02 | $40.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $97.72 Median $144.54 Typical High $151.36 | Professional | 54 · Surgery only | $97.72 | $144.54 | $151.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $28.84 Typical High $30.20 | Professional | 55 · Aftercare only | $19.50 | $28.84 | $30.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $19.05 Typical High $20.42 | Professional | 56 · Pre-op care only | $12.88 | $19.05 | $20.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $91.20 Median $134.90 Typical High $141.25 | Professional | 78 · Unplanned return to OR | $91.20 | $134.90 | $141.25 |
Where Virginia sits
The same service costs 4.6 times more in Alaska than in Florida. 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
$174
AK $603FL $132
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.