How much rates vary
Facilitymedian $1,738 · 10th to 90th $589 to $5,754Professionalmedian $692 · 10th to 90th $537 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 $776.25 Median $1,258.93 Typical High $8,317.64 | Facility | None | $776.25 | $1,258.93 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $575.44 Median $724.44 Typical High $1,071.52 | Professional | None | $575.44 | $724.44 | $1,071.52 |
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 $537.03 Median $691.83 Typical High $912.01 | Professional | None | $537.03 | $691.83 | $912.01 |
CareFirst Setting Professional Modifier None Typical Low $537.03 Median $602.56 Typical High $707.95 | Professional | None | $537.03 | $602.56 | $707.95 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $1,258.93 Typical High $2,570.40 | Facility | None | $524.81 | $1,258.93 | $2,570.40 |
Cigna Setting Professional Modifier None Typical Low $549.54 Median $691.83 Typical High $954.99 | Professional | None | $549.54 | $691.83 | $954.99 |
Kaiser Permanente Setting Professional Modifier None Typical Low $645.65 Median $851.14 Typical High $1,023.29 | Professional | None | $645.65 | $851.14 | $1,023.29 |
Medcost Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $954.99 | Professional | None | $851.14 | $851.14 | $954.99 |
Medcost Setting Facility Modifier None Typical Low $630.96 Median $776.25 Typical High $1,258.93 | Facility | None | $630.96 | $776.25 | $1,258.93 |
Medcost Setting Professional Modifier None Typical Low $3,311.31 Median $3,311.31 Typical High $3,311.31 | Professional | None | $3,311.31 | $3,311.31 | $3,311.31 |
Sentara Setting Facility Modifier None Typical Low $501.19 Median $1,071.52 Typical High $3,630.78 | Facility | None | $501.19 | $1,071.52 | $3,630.78 |
Sentara Setting Professional Modifier None Typical Low $562.34 Median $851.14 Typical High $3,162.28 | Professional | None | $562.34 | $851.14 | $3,162.28 |
United Setting Facility Modifier None Typical Low $588.84 Median $2,187.76 Typical High $5,888.44 | Facility | None | $588.84 | $2,187.76 | $5,888.44 |
United Setting Professional Modifier None Typical Low $467.74 Median $660.69 Typical High $1,148.15 | Professional | None | $467.74 | $660.69 | $1,148.15 |
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 $288.40 Median $316.23 Typical High $389.05 | Professional | 52 · Reduced service | $288.40 | $316.23 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $125.89 Typical High $154.88 | Professional | 53 · Discontinued | $114.82 | $125.89 | $154.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $478.63 Typical High $588.84 | Professional | 54 · Surgery only | $436.52 | $478.63 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $95.50 Typical High $117.49 | Professional | 55 · Aftercare only | $87.10 | $95.50 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $63.10 Typical High $77.62 | Professional | 56 · Pre-op care only | $57.54 | $63.10 | $77.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $407.38 Median $446.68 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $407.38 | $446.68 | $549.54 |
Where Virginia sits
The same service costs 4.3 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· 33rd of 51
$708
AK $2,291TX $537
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.