How much rates vary
Facilitymedian $661 · 10th to 90th $145 to $3,802Professionalmedian $457 · 10th to 90th $339 to $631
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 $407.38 Median $4,365.16 Typical High $14,125.38 | Facility | None | $407.38 | $4,365.16 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $363.08 Median $446.68 Typical High $549.54 | Professional | None | $363.08 | $446.68 | $549.54 |
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 $338.84 Median $446.68 Typical High $616.60 | Professional | None | $338.84 | $446.68 | $616.60 |
CareFirst Setting Professional Modifier None Typical Low $346.74 Median $380.19 Typical High $436.52 | Professional | None | $346.74 | $380.19 | $436.52 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $1,230.27 | Facility | None | $50.12 | $50.12 | $1,230.27 |
Cigna Setting Professional Modifier None Typical Low $346.74 Median $467.74 Typical High $660.69 | Professional | None | $346.74 | $467.74 | $660.69 |
Kaiser Permanente Setting Professional Modifier None Typical Low $426.58 Median $562.34 Typical High $676.08 | Professional | None | $426.58 | $562.34 | $676.08 |
Medcost Setting Professional Modifier None Typical Low $426.58 Median $426.58 Typical High $602.56 | Professional | None | $426.58 | $426.58 | $602.56 |
Medcost Setting Facility Modifier None Typical Low $407.38 Median $549.54 Typical High $891.25 | Facility | None | $407.38 | $549.54 | $891.25 |
Medcost Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $691.83 | Professional | None | $691.83 | $691.83 | $691.83 |
Sentara Setting Facility Modifier None Typical Low $257.04 Median $478.63 Typical High $2,454.71 | Facility | None | $257.04 | $478.63 | $2,454.71 |
Sentara Setting Professional Modifier None Typical Low $263.03 Median $575.44 Typical High $1,479.11 | Professional | None | $263.03 | $575.44 | $1,479.11 |
United Setting Facility Modifier None Typical Low $100.00 Median $660.69 Typical High $2,041.74 | Facility | None | $100.00 | $660.69 | $2,041.74 |
United Setting Professional Modifier None Typical Low $288.40 Median $446.68 Typical High $776.25 | Professional | None | $288.40 | $446.68 | $776.25 |
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 $181.97 Median $204.17 Typical High $275.42 | Professional | 52 · Reduced service | $181.97 | $204.17 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $81.28 Typical High $109.65 | Professional | 53 · Discontinued | $72.44 | $81.28 | $109.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $302.00 Typical High $416.87 | Professional | 54 · Surgery only | $275.42 | $302.00 | $416.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $60.26 Typical High $83.18 | Professional | 55 · Aftercare only | $54.95 | $60.26 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $40.74 Typical High $54.95 | Professional | 56 · Pre-op care only | $36.31 | $40.74 | $54.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $257.04 Median $281.84 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $257.04 | $281.84 | $389.05 |
Where Virginia sits
The same service costs 4.7 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· 27th of 51
$457
AK $1,445TX $309
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.