How much rates vary
Facilitymedian $1,230 · 10th to 90th $204 to $4,786Professionalmedian $275 · 10th to 90th $200 to $398
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 $309.03 Median $3,801.89 Typical High $9,332.54 | Facility | None | $309.03 | $3,801.89 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $208.93 Median $302.00 Typical High $446.68 | Professional | None | $208.93 | $302.00 | $446.68 |
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 $199.53 Median $275.42 Typical High $380.19 | Professional | None | $199.53 | $275.42 | $380.19 |
CareFirst Setting Professional Modifier None Typical Low $199.53 Median $223.87 Typical High $263.03 | Professional | None | $199.53 | $223.87 | $263.03 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $208.93 Typical High $630.96 | Facility | None | $50.12 | $208.93 | $630.96 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $288.40 Typical High $398.11 | Professional | None | $199.53 | $288.40 | $398.11 |
Kaiser Permanente Setting Professional Modifier None Typical Low $269.15 Median $354.81 Typical High $416.87 | Professional | None | $269.15 | $354.81 | $416.87 |
Medcost Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $371.54 | Professional | None | $323.59 | $323.59 | $371.54 |
Medcost Setting Facility Modifier None Typical Low $239.88 Median $331.13 Typical High $549.54 | Facility | None | $239.88 | $331.13 | $549.54 |
Medcost Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $537.03 | Professional | None | $537.03 | $537.03 | $537.03 |
Sentara Setting Facility Modifier None Typical Low $158.49 Median $616.60 Typical High $2,951.21 | Facility | None | $158.49 | $616.60 | $2,951.21 |
Sentara Setting Professional Modifier None Typical Low $204.17 Median $354.81 Typical High $1,737.80 | Professional | None | $204.17 | $354.81 | $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 $173.78 Median $269.15 Typical High $478.63 | Professional | None | $173.78 | $269.15 | $478.63 |
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 $104.71 Median $123.03 Typical High $165.96 | Professional | 52 · Reduced service | $104.71 | $123.03 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $48.98 Typical High $67.61 | Professional | 53 · Discontinued | $41.69 | $48.98 | $67.61 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $158.49 Median $181.97 Typical High $251.19 | Professional | 54 · Surgery only | $158.49 | $181.97 | $251.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $36.31 Typical High $50.12 | Professional | 55 · Aftercare only | $31.62 | $36.31 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $24.55 Typical High $33.11 | Professional | 56 · Pre-op care only | $20.89 | $24.55 | $33.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $147.91 Median $169.82 Typical High $234.42 | Professional | 78 · Unplanned return to OR | $147.91 | $169.82 | $234.42 |
Where Virginia sits
The same service costs 3.9 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· 36th of 51
$282
AK $851TX $219
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.