How much rates vary
Facilitymedian $1,862 · 10th to 90th $646 to $5,888Professionalmedian $776 · 10th to 90th $617 to $1,096
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 $3,548.13 Typical High $9,332.54 | Facility | None | $794.33 | $3,548.13 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $645.65 Median $794.33 Typical High $1,202.26 | Professional | None | $645.65 | $794.33 | $1,202.26 |
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 $602.56 Median $776.25 Typical High $1,023.29 | Professional | None | $602.56 | $776.25 | $1,023.29 |
CareFirst Setting Professional Modifier None Typical Low $616.60 Median $676.08 Typical High $794.33 | Professional | None | $616.60 | $676.08 | $794.33 |
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 $616.60 Median $758.58 Typical High $1,096.48 | Professional | None | $616.60 | $758.58 | $1,096.48 |
Kaiser Permanente Setting Professional Modifier None Typical Low $724.44 Median $933.25 Typical High $1,122.02 | Professional | None | $724.44 | $933.25 | $1,122.02 |
Medcost Setting Professional Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $1,174.90 | Professional | None | $1,000.00 | $1,000.00 | $1,174.90 |
Medcost Setting Facility Modifier None Typical Low $758.58 Median $891.25 Typical High $1,479.11 | Facility | None | $758.58 | $891.25 | $1,479.11 |
Medcost Setting Professional Modifier None Typical Low $3,715.35 Median $3,715.35 Typical High $3,715.35 | Professional | None | $3,715.35 | $3,715.35 | $3,715.35 |
Sentara Setting Facility Modifier None Typical Low $588.84 Median $1,174.90 Typical High $3,715.35 | Facility | None | $588.84 | $1,174.90 | $3,715.35 |
Sentara Setting Professional Modifier None Typical Low $707.95 Median $977.24 Typical High $3,388.44 | Professional | None | $707.95 | $977.24 | $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 $537.03 Median $776.25 Typical High $1,318.26 | Professional | None | $537.03 | $776.25 | $1,318.26 |
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 $323.59 Median $371.54 Typical High $446.68 | Professional | 52 · Reduced service | $323.59 | $371.54 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $151.36 Typical High $177.83 | Professional | 53 · Discontinued | $131.83 | $151.36 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $562.34 Typical High $676.08 | Professional | 54 · Surgery only | $489.78 | $562.34 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $112.20 Typical High $134.90 | Professional | 55 · Aftercare only | $97.72 | $112.20 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $75.86 Typical High $89.13 | Professional | 56 · Pre-op care only | $64.57 | $75.86 | $89.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $524.81 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $457.09 | $524.81 | $630.96 |
Where Virginia sits
The same service costs 4.5 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
$794
AK $2,630TX $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.