How much rates vary
Facilitymedian $617 · 10th to 90th $151 to $4,074Professionalmedian $316 · 10th to 90th $229 to $603
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 $316.23 Median $4,073.80 Typical High $10,000.00 | Facility | None | $316.23 | $4,073.80 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $218.78 Median $371.54 Typical High $575.44 | Professional | None | $218.78 | $371.54 | $575.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,698.24 Median $2,398.83 Typical High $2,951.21 | Facility | None | $1,698.24 | $2,398.83 | $2,951.21 |
Anthem BCBS Setting Professional Modifier None Typical Low $234.42 Median $288.40 Typical High $331.13 | Professional | None | $234.42 | $288.40 | $331.13 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $354.81 Median $426.58 Typical High $501.19 | Professional | 50 · Both sides | $354.81 | $426.58 | $501.19 |
CareFirst Setting Professional Modifier None Typical Low $245.47 Median $275.42 Typical High $323.59 | Professional | None | $245.47 | $275.42 | $323.59 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $199.53 Typical High $707.95 | Facility | None | $50.12 | $199.53 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $389.05 Typical High $562.34 | Professional | None | $229.09 | $389.05 | $562.34 |
Kaiser Permanente Setting Professional Modifier None Typical Low $416.87 Median $501.19 Typical High $616.60 | Professional | None | $416.87 | $501.19 | $616.60 |
Medcost Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $707.95 | Professional | None | $691.83 | $691.83 | $707.95 |
Medcost Setting Facility Modifier None Typical Low $218.78 Median $371.54 Typical High $776.25 | Facility | None | $218.78 | $371.54 | $776.25 |
Medcost Setting Professional Modifier None Typical Low $501.19 Median $501.19 Typical High $501.19 | Professional | None | $501.19 | $501.19 | $501.19 |
Sentara Setting Facility Modifier None Typical Low $234.42 Median $478.63 Typical High $2,454.71 | Facility | None | $234.42 | $478.63 | $2,454.71 |
Sentara Setting Professional Modifier None Typical Low $436.52 Median $575.44 Typical High $1,174.90 | Professional | None | $436.52 | $575.44 | $1,174.90 |
United Setting Facility Modifier None Typical Low $100.00 Median $660.69 Typical High $2,041.74 | Facility | None | $100.00 | $660.69 | $2,041.74 |
United Setting Professional Modifier None Typical Low $199.53 Median $346.74 Typical High $645.65 | Professional | None | $199.53 | $346.74 | $645.65 |
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 $109.65 Median $186.21 Typical High $281.84 | Professional | 52 · Reduced service | $109.65 | $186.21 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $74.13 Typical High $114.82 | Professional | 53 · Discontinued | $44.67 | $74.13 | $114.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $165.96 Median $275.42 Typical High $426.58 | Professional | 54 · Surgery only | $165.96 | $275.42 | $426.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $56.23 Typical High $85.11 | Professional | 55 · Aftercare only | $33.11 | $56.23 | $85.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $37.15 Typical High $57.54 | Professional | 56 · Pre-op care only | $21.88 | $37.15 | $57.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $154.88 Median $257.04 Typical High $398.11 | Professional | 78 · Unplanned return to OR | $154.88 | $257.04 | $398.11 |
Where Virginia sits
The same service costs 3.4 times more in Alaska than in Maryland. 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· 46th of 51
$324
AK $1,023MD $302
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.