How much rates vary
Facilitymedian $2,138 · 10th to 90th $603 to $5,888Professionalmedian $741 · 10th to 90th $575 to $1,047
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 $794.33 Median $3,981.07 Typical High $9,332.54 | Facility | None | $794.33 | $3,981.07 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $616.60 Median $741.31 Typical High $1,380.38 | Professional | None | $616.60 | $741.31 | $1,380.38 |
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 $575.44 Median $741.31 Typical High $1,000.00 | Professional | None | $575.44 | $741.31 | $1,000.00 |
CareFirst Setting Professional Modifier None Typical Low $575.44 Median $645.65 Typical High $758.58 | Professional | None | $575.44 | $645.65 | $758.58 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $1,174.90 Typical High $2,187.76 | Facility | None | $478.63 | $1,174.90 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $588.84 Median $741.31 Typical High $1,047.13 | Professional | None | $588.84 | $741.31 | $1,047.13 |
Kaiser Permanente Setting Professional Modifier None Typical Low $707.95 Median $933.25 Typical High $1,096.48 | Professional | None | $707.95 | $933.25 | $1,096.48 |
Medcost Setting Professional Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $1,096.48 | Professional | None | $1,000.00 | $1,000.00 | $1,096.48 |
Medcost Setting Facility Modifier None Typical Low $691.83 Median $870.96 Typical High $1,412.54 | Facility | None | $691.83 | $870.96 | $1,412.54 |
Medcost Setting Professional Modifier None Typical Low $3,890.45 Median $3,890.45 Typical High $3,890.45 | Professional | None | $3,890.45 | $3,890.45 | $3,890.45 |
Sentara Setting Facility Modifier None Typical Low $549.54 Median $1,148.15 Typical High $3,630.78 | Facility | None | $549.54 | $1,148.15 | $3,630.78 |
Sentara Setting Professional Modifier None Typical Low $660.69 Median $933.25 Typical High $3,388.44 | Professional | None | $660.69 | $933.25 | $3,388.44 |
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 $512.86 Median $741.31 Typical High $1,258.93 | Professional | None | $512.86 | $741.31 | $1,258.93 |
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 $309.03 Median $346.74 Typical High $426.58 | Professional | 52 · Reduced service | $309.03 | $346.74 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $138.04 Typical High $173.78 | Professional | 53 · Discontinued | $123.03 | $138.04 | $173.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $512.86 Typical High $645.65 | Professional | 54 · Surgery only | $467.74 | $512.86 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $104.71 Typical High $128.82 | Professional | 55 · Aftercare only | $93.33 | $104.71 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $69.18 Typical High $87.10 | Professional | 56 · Pre-op care only | $61.66 | $69.18 | $87.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $478.63 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $436.52 | $478.63 | $602.56 |
Where Virginia sits
The same service costs 4.2 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
$759
AK $2,455TX $589
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.