How much rates vary
Facilitymedian $955 · 10th to 90th $219 to $4,365Professionalmedian $257 · 10th to 90th $182 to $380
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 $275.42 Median $537.03 Typical High $8,317.64 | Facility | None | $275.42 | $537.03 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $194.98 Median $288.40 Typical High $426.58 | Professional | None | $194.98 | $288.40 | $426.58 |
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 $181.97 Median $251.19 Typical High $354.81 | Professional | None | $181.97 | $251.19 | $354.81 |
CareFirst Setting Professional Modifier None Typical Low $194.98 Median $213.80 Typical High $257.04 | Professional | None | $194.98 | $213.80 | $257.04 |
Cigna Setting Facility Modifier None Typical Low $173.78 Median $331.13 Typical High $1,621.81 | Facility | None | $173.78 | $331.13 | $1,621.81 |
Cigna Setting Professional Modifier None Typical Low $186.21 Median $263.03 Typical High $371.54 | Professional | None | $186.21 | $263.03 | $371.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $251.19 Median $331.13 Typical High $389.05 | Professional | None | $251.19 | $331.13 | $389.05 |
Medcost Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $323.59 | Professional | None | $288.40 | $288.40 | $323.59 |
Medcost Setting Facility Modifier None Typical Low $218.78 Median $316.23 Typical High $512.86 | Facility | None | $218.78 | $316.23 | $512.86 |
Medcost Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $478.63 | Professional | None | $478.63 | $478.63 | $478.63 |
Sentara Setting Facility Modifier None Typical Low $134.90 Median $616.60 Typical High $2,951.21 | Facility | None | $134.90 | $616.60 | $2,951.21 |
Sentara Setting Professional Modifier None Typical Low $190.55 Median $331.13 Typical High $1,737.80 | Professional | None | $190.55 | $331.13 | $1,737.80 |
United Setting Facility Modifier None Typical Low $323.59 Median $1,445.44 Typical High $3,630.78 | Facility | None | $323.59 | $1,445.44 | $3,630.78 |
United Setting Professional Modifier None Typical Low $158.49 Median $251.19 Typical High $446.68 | Professional | None | $158.49 | $251.19 | $446.68 |
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 $97.72 Median $114.82 Typical High $158.49 | Professional | 52 · Reduced service | $97.72 | $114.82 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $45.71 Typical High $63.10 | Professional | 53 · Discontinued | $38.90 | $45.71 | $63.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $169.82 Typical High $234.42 | Professional | 54 · Surgery only | $144.54 | $169.82 | $234.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $33.88 Typical High $47.86 | Professional | 55 · Aftercare only | $29.51 | $33.88 | $47.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $22.91 Typical High $31.62 | Professional | 56 · Pre-op care only | $19.50 | $22.91 | $31.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $134.90 Median $158.49 Typical High $218.78 | Professional | 78 · Unplanned return to OR | $134.90 | $158.49 | $218.78 |
Where Virginia sits
The same service costs 3.6 times more in Alaska than in Texas. 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
$269
AK $776TX $214
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.