How much rates vary
Facilitymedian $1,230 · 10th to 90th $339 to $4,786Professionalmedian $479 · 10th to 90th $355 to $708
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 $467.74 Median $4,365.16 Typical High $14,125.38 | Facility | None | $467.74 | $4,365.16 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $380.19 Median $467.74 Typical High $645.65 | Professional | None | $380.19 | $467.74 | $645.65 |
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 $354.81 Median $457.09 Typical High $630.96 | Professional | None | $354.81 | $457.09 | $630.96 |
CareFirst Setting Professional Modifier None Typical Low $380.19 Median $426.58 Typical High $489.78 | Professional | None | $380.19 | $426.58 | $489.78 |
Cigna Setting Facility Modifier None Typical Low $316.23 Median $478.63 Typical High $1,621.81 | Facility | None | $316.23 | $478.63 | $1,621.81 |
Cigna Setting Professional Modifier None Typical Low $363.08 Median $478.63 Typical High $741.31 | Professional | None | $363.08 | $478.63 | $741.31 |
Kaiser Permanente Setting Professional Modifier None Typical Low $436.52 Median $562.34 Typical High $676.08 | Professional | None | $436.52 | $562.34 | $676.08 |
Medcost Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $851.14 | Professional | None | $467.74 | $467.74 | $851.14 |
Medcost Setting Facility Modifier None Typical Low $467.74 Median $645.65 Typical High $1,047.13 | Facility | None | $467.74 | $645.65 | $1,047.13 |
Medcost Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $758.58 | Professional | None | $758.58 | $758.58 | $758.58 |
Sentara Setting Facility Modifier None Typical Low $389.05 Median $741.31 Typical High $3,467.37 | Facility | None | $389.05 | $741.31 | $3,467.37 |
Sentara Setting Professional Modifier None Typical Low $398.11 Median $707.95 Typical High $2,454.71 | Professional | None | $398.11 | $707.95 | $2,454.71 |
United Setting Facility Modifier None Typical Low $323.59 Median $1,445.44 Typical High $3,981.07 | Facility | None | $323.59 | $1,445.44 | $3,981.07 |
United Setting Professional Modifier None Typical Low $346.74 Median $524.81 Typical High $933.25 | Professional | None | $346.74 | $524.81 | $933.25 |
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 $190.55 Median $234.42 Typical High $323.59 | Professional | 52 · Reduced service | $190.55 | $234.42 | $323.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $93.33 Typical High $128.82 | Professional | 53 · Discontinued | $75.86 | $93.33 | $128.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $281.84 Median $346.74 Typical High $478.63 | Professional | 54 · Surgery only | $281.84 | $346.74 | $478.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $69.18 Typical High $95.50 | Professional | 55 · Aftercare only | $56.23 | $69.18 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $46.77 Typical High $64.57 | Professional | 56 · Pre-op care only | $38.02 | $46.77 | $64.57 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $263.03 Median $323.59 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $263.03 | $323.59 | $446.68 |
Where Virginia sits
The same service costs 5.1 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
$490
AK $1,514TX $295
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.