How much rates vary
Facilitymedian $661 · 10th to 90th $151 to $3,388Professionalmedian $513 · 10th to 90th $389 to $724
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 $416.87 Median $489.78 Typical High $616.60 | Professional | None | $416.87 | $489.78 | $616.60 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,698.24 Median $2,398.83 Typical High $2,951.21 | Facility | None | $1,698.24 | $2,398.83 | $2,951.21 |
Anthem BCBS Setting Professional Modifier None Typical Low $389.05 Median $501.19 Typical High $691.83 | Professional | None | $389.05 | $501.19 | $691.83 |
CareFirst Setting Professional Modifier None Typical Low $398.11 Median $436.52 Typical High $501.19 | Professional | None | $398.11 | $436.52 | $501.19 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $363.08 Typical High $676.08 | Facility | None | $50.12 | $363.08 | $676.08 |
Cigna Setting Professional Modifier None Typical Low $398.11 Median $524.81 Typical High $758.58 | Professional | None | $398.11 | $524.81 | $758.58 |
Kaiser Permanente Setting Professional Modifier None Typical Low $478.63 Median $630.96 Typical High $741.31 | Professional | None | $478.63 | $630.96 | $741.31 |
Medcost Setting Professional Modifier None Typical Low $602.56 Median $602.56 Typical High $776.25 | Professional | None | $602.56 | $602.56 | $776.25 |
Medcost Setting Facility Modifier None Typical Low $467.74 Median $616.60 Typical High $1,000.00 | Facility | None | $467.74 | $616.60 | $1,000.00 |
Medcost Setting Professional Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $1,000.00 | Professional | None | $1,000.00 | $1,000.00 | $1,000.00 |
Sentara Setting Facility Modifier None Typical Low $363.08 Median $549.54 Typical High $2,454.71 | Facility | None | $363.08 | $549.54 | $2,454.71 |
Sentara Setting Professional Modifier None Typical Low $398.11 Median $660.69 Typical High $1,479.11 | Professional | None | $398.11 | $660.69 | $1,479.11 |
United Setting Facility Modifier None Typical Low $100.00 Median $660.69 Typical High $2,089.30 | Facility | None | $100.00 | $660.69 | $2,089.30 |
United Setting Professional Modifier None Typical Low $346.74 Median $512.86 Typical High $891.25 | Professional | None | $346.74 | $512.86 | $891.25 |
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 $208.93 Median $234.42 Typical High $309.03 | Professional | 52 · Reduced service | $208.93 | $234.42 | $309.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $93.33 Typical High $123.03 | Professional | 53 · Discontinued | $83.18 | $93.33 | $123.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $346.74 Typical High $457.09 | Professional | 54 · Surgery only | $316.23 | $346.74 | $457.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $69.18 Typical High $93.33 | Professional | 55 · Aftercare only | $63.10 | $69.18 | $93.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $46.77 Typical High $61.66 | Professional | 56 · Pre-op care only | $41.69 | $46.77 | $61.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $295.12 Median $323.59 Typical High $426.58 | Professional | 78 · Unplanned return to OR | $295.12 | $323.59 | $426.58 |
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· 29th of 51
$513
AK $1,660TX $324
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.