How much rates vary
Facilitymedian $5,248 · 10th to 90th $1,023 to $13,490Professionalmedian $1,259 · 10th to 90th $1,023 to $1,950
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 $1,258.93 Median $5,370.32 Typical High $10,000.00 | Facility | None | $1,258.93 | $5,370.32 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $1,174.90 Median $1,202.26 Typical High $3,801.89 | Professional | None | $1,174.90 | $1,202.26 | $3,801.89 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,165.95 Median $7,413.10 Typical High $9,549.93 | Facility | None | $6,165.95 | $7,413.10 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,047.13 Median $1,258.93 Typical High $1,621.81 | Professional | None | $1,047.13 | $1,258.93 | $1,621.81 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,584.89 Median $1,905.46 Typical High $2,398.83 | Professional | 50 · Both sides | $1,584.89 | $1,905.46 | $2,398.83 |
CareFirst Setting Professional Modifier None Typical Low $1,071.52 Median $1,174.90 Typical High $4,466.84 | Professional | None | $1,071.52 | $1,174.90 | $4,466.84 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $2,691.53 Typical High $5,754.40 | Facility | None | $524.81 | $2,691.53 | $5,754.40 |
Cigna Setting Professional Modifier None Typical Low $1,096.48 Median $1,258.93 Typical High $1,862.09 | Professional | None | $1,096.48 | $1,258.93 | $1,862.09 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,000.00 Median $1,202.26 Typical High $1,479.11 | Professional | None | $1,000.00 | $1,202.26 | $1,479.11 |
Medcost Setting Professional Modifier None Typical Low $1,348.96 Median $1,659.59 Typical High $1,659.59 | Professional | None | $1,348.96 | $1,659.59 | $1,659.59 |
Medcost Setting Facility Modifier None Typical Low $1,202.26 Median $1,412.54 Typical High $1,995.26 | Facility | None | $1,202.26 | $1,412.54 | $1,995.26 |
Medcost Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,318.26 | Professional | None | $1,318.26 | $1,318.26 | $1,318.26 |
Sentara Setting Facility Modifier None Typical Low $891.25 Median $2,511.89 Typical High $10,232.93 | Facility | None | $891.25 | $2,511.89 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $933.25 Median $1,412.54 Typical High $7,413.10 | Professional | None | $933.25 | $1,412.54 | $7,413.10 |
United Setting Facility Modifier None Typical Low $1,995.26 Median $8,511.38 Typical High $20,417.38 | Facility | None | $1,995.26 | $8,511.38 | $20,417.38 |
United Setting Professional Modifier None Typical Low $891.25 Median $1,445.44 Typical High $2,187.76 | Professional | None | $891.25 | $1,445.44 | $2,187.76 |
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 $588.84 Median $602.56 Typical High $630.96 | Professional | 52 · Reduced service | $588.84 | $602.56 | $630.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $245.47 Typical High $251.19 | Professional | 53 · Discontinued | $234.42 | $245.47 | $251.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $912.01 Typical High $933.25 | Professional | 54 · Surgery only | $870.96 | $912.01 | $933.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $181.97 Typical High $186.21 | Professional | 55 · Aftercare only | $177.83 | $181.97 | $186.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $120.23 Typical High $125.89 | Professional | 56 · Pre-op care only | $117.49 | $120.23 | $125.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $851.14 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $812.83 | $851.14 | $870.96 |
Where Virginia sits
The same service costs 4.3 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 $11,815WV $2,762
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.