How much rates vary
Facilitymedian $1,820 · 10th to 90th $708 to $5,623Professionalmedian $1,000 · 10th to 90th $794 to $1,413
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 $1,023.29 Median $1,548.82 Typical High $7,244.36 | Facility | None | $1,023.29 | $1,548.82 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $851.14 Median $1,023.29 Typical High $1,698.24 | Professional | None | $851.14 | $1,023.29 | $1,698.24 |
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 $794.33 Median $1,000.00 Typical High $1,318.26 | Professional | None | $794.33 | $1,000.00 | $1,318.26 |
CareFirst Setting Professional Modifier None Typical Low $794.33 Median $891.25 Typical High $1,047.13 | Professional | None | $794.33 | $891.25 | $1,047.13 |
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 $812.83 Median $977.24 Typical High $1,348.96 | Professional | None | $812.83 | $977.24 | $1,348.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $912.01 Median $1,174.90 Typical High $1,412.54 | Professional | None | $912.01 | $1,174.90 | $1,412.54 |
Medcost Setting Professional Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $1,288.25 | Professional | None | $1,071.52 | $1,071.52 | $1,288.25 |
Medcost Setting Facility Modifier None Typical Low $954.99 Median $1,122.02 Typical High $1,862.09 | Facility | None | $954.99 | $1,122.02 | $1,862.09 |
Medcost Setting Professional Modifier None Typical Low $4,073.80 Median $4,073.80 Typical High $4,073.80 | Professional | None | $4,073.80 | $4,073.80 | $4,073.80 |
Sentara Setting Facility Modifier None Typical Low $707.95 Median $1,258.93 Typical High $3,801.89 | Facility | None | $707.95 | $1,258.93 | $3,801.89 |
Sentara Setting Professional Modifier None Typical Low $891.25 Median $1,202.26 Typical High $3,388.44 | Professional | None | $891.25 | $1,202.26 | $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 $691.83 Median $954.99 Typical High $1,659.59 | Professional | None | $691.83 | $954.99 | $1,659.59 |
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 $416.87 Median $478.63 Typical High $562.34 | Professional | 52 · Reduced service | $416.87 | $478.63 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $194.98 Typical High $223.87 | Professional | 53 · Discontinued | $165.96 | $194.98 | $223.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $724.44 Typical High $851.14 | Professional | 54 · Surgery only | $630.96 | $724.44 | $851.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $144.54 Typical High $169.82 | Professional | 55 · Aftercare only | $125.89 | $144.54 | $169.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $95.50 Typical High $112.20 | Professional | 56 · Pre-op care only | $83.18 | $95.50 | $112.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $676.08 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $588.84 | $676.08 | $794.33 |
Where Virginia sits
The same service costs 4.4 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· 30th of 51
$1,023
AK $3,311TX $759
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.