How much rates vary
Facilitymedian $2,754 · 10th to 90th $389 to $9,550Professionalmedian $380 · 10th to 90th $302 to $537
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 $389.05 Median $4,073.80 Typical High $9,332.54 | Facility | None | $389.05 | $4,073.80 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $316.23 Median $389.05 Typical High $660.69 | Professional | None | $316.23 | $389.05 | $660.69 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,677.35 Median $6,456.54 Typical High $7,244.36 | Facility | None | $4,677.35 | $6,456.54 | $7,244.36 |
Anthem BCBS Setting Professional Modifier None Typical Low $302.00 Median $380.19 Typical High $501.19 | Professional | None | $302.00 | $380.19 | $501.19 |
CareFirst Setting Professional Modifier None Typical Low $302.00 Median $338.84 Typical High $398.11 | Professional | None | $302.00 | $338.84 | $398.11 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $1,288.25 Typical High $2,344.23 | Facility | None | $478.63 | $1,288.25 | $2,344.23 |
Cigna Setting Professional Modifier None Typical Low $302.00 Median $371.54 Typical High $524.81 | Professional | None | $302.00 | $371.54 | $524.81 |
Kaiser Permanente Setting Professional Modifier None Typical Low $354.81 Median $467.74 Typical High $562.34 | Professional | None | $354.81 | $467.74 | $562.34 |
Medcost Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $549.54 | Professional | None | $467.74 | $467.74 | $549.54 |
Medcost Setting Facility Modifier None Typical Low $363.08 Median $436.52 Typical High $707.95 | Facility | None | $363.08 | $436.52 | $707.95 |
Medcost Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $758.58 | Professional | None | $758.58 | $758.58 | $758.58 |
Sentara Setting Facility Modifier None Typical Low $275.42 Median $1,202.26 Typical High $8,709.64 | Facility | None | $275.42 | $1,202.26 | $8,709.64 |
Sentara Setting Professional Modifier None Typical Low $275.42 Median $457.09 Typical High $5,128.61 | Professional | None | $275.42 | $457.09 | $5,128.61 |
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 $263.03 Median $371.54 Typical High $630.96 | Professional | None | $263.03 | $371.54 | $630.96 |
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 $158.49 Median $181.97 Typical High $218.78 | Professional | 52 · Reduced service | $158.49 | $181.97 | $218.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $72.44 Typical High $87.10 | Professional | 53 · Discontinued | $63.10 | $72.44 | $87.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $275.42 Typical High $331.13 | Professional | 54 · Surgery only | $239.88 | $275.42 | $331.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $54.95 Typical High $66.07 | Professional | 55 · Aftercare only | $47.86 | $54.95 | $66.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $36.31 Typical High $43.65 | Professional | 56 · Pre-op care only | $31.62 | $36.31 | $43.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $223.87 Median $257.04 Typical High $309.03 | Professional | 78 · Unplanned return to OR | $223.87 | $257.04 | $309.03 |
Where Virginia sits
The same service costs 4.5 times more in Alaska than in New Jersey. 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· 36th of 51
$389
AK $1,549NJ $347
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.