How much rates vary
Facilitymedian $1,514 · 10th to 90th $490 to $6,457Professionalmedian $661 · 10th to 90th $537 to $955
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 $794.33 Median $5,623.41 Typical High $10,964.78 | Facility | None | $794.33 | $5,623.41 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $537.03 Median $794.33 Typical High $3,981.07 | Professional | None | $537.03 | $794.33 | $3,981.07 |
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 $575.44 Median $691.83 Typical High $812.83 | Professional | None | $575.44 | $691.83 | $812.83 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $870.96 Median $1,047.13 Typical High $1,230.27 | Professional | 50 · Both sides | $870.96 | $1,047.13 | $1,230.27 |
CareFirst Setting Professional Modifier None Typical Low $588.84 Median $645.65 Typical High $758.58 | Professional | None | $588.84 | $645.65 | $758.58 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $1,288.25 Typical High $2,951.21 | Facility | None | $645.65 | $1,288.25 | $2,951.21 |
Cigna Setting Professional Modifier None Typical Low $562.34 Median $602.56 Typical High $870.96 | Professional | None | $562.34 | $602.56 | $870.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $524.81 Median $602.56 Typical High $741.31 | Professional | None | $524.81 | $602.56 | $741.31 |
Medcost Setting Professional Modifier None Typical Low $758.58 Median $1,047.13 Typical High $1,047.13 | Professional | None | $758.58 | $1,047.13 | $1,047.13 |
Medcost Setting Facility Modifier None Typical Low $537.03 Median $707.95 Typical High $1,148.15 | Facility | None | $537.03 | $707.95 | $1,148.15 |
Medcost Setting Professional Modifier None Typical Low $724.44 Median $724.44 Typical High $724.44 | Professional | None | $724.44 | $724.44 | $724.44 |
Sentara Setting Facility Modifier None Typical Low $467.74 Median $933.25 Typical High $3,311.31 | Facility | None | $467.74 | $933.25 | $3,311.31 |
Sentara Setting Professional Modifier None Typical Low $588.84 Median $812.83 Typical High $2,290.87 | Professional | None | $588.84 | $812.83 | $2,290.87 |
United Setting Facility Modifier None Typical Low $323.59 Median $1,445.44 Typical High $3,981.07 | Facility | None | $323.59 | $1,445.44 | $3,981.07 |
United Setting Professional Modifier None Typical Low $416.87 Median $549.54 Typical High $1,023.29 | Professional | None | $416.87 | $549.54 | $1,023.29 |
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 $269.15 Median $398.11 Typical High $398.11 | Professional | 52 · Reduced service | $269.15 | $398.11 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $158.49 Typical High $158.49 | Professional | 53 · Discontinued | $109.65 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $588.84 Typical High $588.84 | Professional | 54 · Surgery only | $407.38 | $588.84 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $120.23 Typical High $120.23 | Professional | 55 · Aftercare only | $81.28 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $79.43 Typical High $79.43 | Professional | 56 · Pre-op care only | $53.70 | $79.43 | $79.43 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $380.19 Median $549.54 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $380.19 | $549.54 | $549.54 |
Where Virginia sits
The same service costs 7.6 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· 34th of 51
$708
AK $2,512UT $331
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.