How much rates vary
Facilitymedian $3,020 · 10th to 90th $537 to $9,550Professionalmedian $646 · 10th to 90th $457 to $977
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 $537.03 Median $5,248.07 Typical High $10,000.00 | Facility | None | $537.03 | $5,248.07 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $512.86 Median $645.65 Typical High $724.44 | Professional | None | $512.86 | $645.65 | $724.44 |
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 $467.74 Median $630.96 Typical High $870.96 | Professional | None | $467.74 | $630.96 | $870.96 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $691.83 Median $933.25 Typical High $1,288.25 | Professional | 50 · Both sides | $691.83 | $933.25 | $1,288.25 |
CareFirst Setting Professional Modifier None Typical Low $446.68 Median $501.19 Typical High $3,890.45 | Professional | None | $446.68 | $501.19 | $3,890.45 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $1,513.56 Typical High $2,818.38 | Facility | None | $524.81 | $1,513.56 | $2,818.38 |
Cigna Setting Professional Modifier None Typical Low $478.63 Median $660.69 Typical High $1,023.29 | Professional | None | $478.63 | $660.69 | $1,023.29 |
Kaiser Permanente Setting Professional Modifier None Typical Low $416.87 Median $758.58 Typical High $933.25 | Professional | None | $416.87 | $758.58 | $933.25 |
Medcost Setting Professional Modifier None Typical Low $575.44 Median $741.31 Typical High $741.31 | Professional | None | $575.44 | $741.31 | $741.31 |
Medcost Setting Facility Modifier None Typical Low $537.03 Median $707.95 Typical High $1,174.90 | Facility | None | $537.03 | $707.95 | $1,174.90 |
Medcost Setting Professional Modifier None Typical Low $794.33 Median $794.33 Typical High $794.33 | Professional | None | $794.33 | $794.33 | $794.33 |
Sentara Setting Facility Modifier None Typical Low $407.38 Median $1,737.80 Typical High $8,709.64 | Facility | None | $407.38 | $1,737.80 | $8,709.64 |
Sentara Setting Professional Modifier None Typical Low $524.81 Median $870.96 Typical High $4,570.88 | Professional | None | $524.81 | $870.96 | $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 $407.38 Median $660.69 Typical High $1,122.02 | Professional | None | $407.38 | $660.69 | $1,122.02 |
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 $257.04 Median $288.40 Typical High $363.08 | Professional | 52 · Reduced service | $257.04 | $288.40 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $114.82 Typical High $144.54 | Professional | 53 · Discontinued | $102.33 | $114.82 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $426.58 Typical High $549.54 | Professional | 54 · Surgery only | $380.19 | $426.58 | $549.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $87.10 Typical High $109.65 | Professional | 55 · Aftercare only | $77.62 | $87.10 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $57.54 Typical High $72.44 | Professional | 56 · Pre-op care only | $51.29 | $57.54 | $72.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $354.81 Median $398.11 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $354.81 | $398.11 | $512.86 |
Where Virginia sits
The same service costs 4.1 times more in Alaska than in Kentucky. 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· 45th of 51
$661
AK $2,291KY $562
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.