How much rates vary
Facilitymedian $2,138 · 10th to 90th $646 to $6,918Professionalmedian $851 · 10th to 90th $676 to $1,148
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 $812.83 Median $4,365.16 Typical High $10,000.00 | Facility | None | $812.83 | $4,365.16 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $724.44 Median $812.83 Typical High $954.99 | Professional | None | $724.44 | $812.83 | $954.99 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,677.35 Median $6,456.54 Typical High $7,244.36 | Facility | None | $4,677.35 | $6,456.54 | $7,244.36 |
Anthem BCBS Setting Professional Modifier None Typical Low $676.08 Median $851.14 Typical High $1,122.02 | Professional | None | $676.08 | $851.14 | $1,122.02 |
CareFirst Setting Professional Modifier None Typical Low $691.83 Median $776.25 Typical High $912.01 | Professional | None | $691.83 | $776.25 | $912.01 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $1,412.54 Typical High $2,691.53 | Facility | None | $512.86 | $1,412.54 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $691.83 Median $851.14 Typical High $1,148.15 | Professional | None | $691.83 | $851.14 | $1,148.15 |
Kaiser Permanente Setting Professional Modifier None Typical Low $851.14 Median $1,122.02 Typical High $1,318.26 | Professional | None | $851.14 | $1,122.02 | $1,318.26 |
Medcost Setting Professional Modifier None Typical Low $912.01 Median $912.01 Typical High $1,122.02 | Professional | None | $912.01 | $912.01 | $1,122.02 |
Medcost Setting Facility Modifier None Typical Low $812.83 Median $954.99 Typical High $1,584.89 | Facility | None | $812.83 | $954.99 | $1,584.89 |
Medcost Setting Professional Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $1,479.11 | Professional | None | $1,479.11 | $1,479.11 | $1,479.11 |
Sentara Setting Facility Modifier None Typical Low $602.56 Median $1,174.90 Typical High $3,715.35 | Facility | None | $602.56 | $1,174.90 | $3,715.35 |
Sentara Setting Professional Modifier None Typical Low $707.95 Median $1,000.00 Typical High $3,388.44 | Professional | None | $707.95 | $1,000.00 | $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 $575.44 Median $831.76 Typical High $1,380.38 | Professional | None | $575.44 | $831.76 | $1,380.38 |
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 $363.08 Median $407.38 Typical High $478.63 | Professional | 52 · Reduced service | $363.08 | $407.38 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $162.18 Typical High $194.98 | Professional | 53 · Discontinued | $144.54 | $162.18 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $602.56 Typical High $724.44 | Professional | 54 · Surgery only | $537.03 | $602.56 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $120.23 Typical High $144.54 | Professional | 55 · Aftercare only | $107.15 | $120.23 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $81.28 Typical High $95.50 | Professional | 56 · Pre-op care only | $72.44 | $81.28 | $95.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $562.34 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $501.19 | $562.34 | $676.08 |
Where Virginia sits
The same service costs 4.9 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
$871
AK $2,884TX $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.