How much rates vary
Facilitymedian $2,138 · 10th to 90th $603 to $6,918Professionalmedian $692 · 10th to 90th $575 to $977
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 $724.44 Median $4,786.30 Typical High $14,125.38 | Facility | None | $724.44 | $4,786.30 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $602.56 Median $660.69 Typical High $3,235.94 | Professional | None | $602.56 | $660.69 | $3,235.94 |
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 $588.84 Median $707.95 Typical High $870.96 | Professional | None | $588.84 | $707.95 | $870.96 |
CareFirst Setting Professional Modifier None Typical Low $630.96 Median $707.95 Typical High $831.76 | Professional | None | $630.96 | $707.95 | $831.76 |
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 $562.34 Median $660.69 Typical High $977.24 | Professional | None | $562.34 | $660.69 | $977.24 |
Kaiser Permanente Setting Professional Modifier None Typical Low $575.44 Median $707.95 Typical High $831.76 | Professional | None | $575.44 | $707.95 | $831.76 |
Medcost Setting Professional Modifier None Typical Low $724.44 Median $724.44 Typical High $851.14 | Professional | None | $724.44 | $724.44 | $851.14 |
Medcost Setting Facility Modifier None Typical Low $724.44 Median $741.31 Typical High $1,174.90 | Facility | None | $724.44 | $741.31 | $1,174.90 |
Medcost Setting Professional Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,174.90 | Professional | None | $1,174.90 | $1,174.90 | $1,174.90 |
Sentara Setting Facility Modifier None Typical Low $501.19 Median $1,174.90 Typical High $3,630.78 | Facility | None | $501.19 | $1,174.90 | $3,630.78 |
Sentara Setting Professional Modifier None Typical Low $467.74 Median $724.44 Typical High $3,162.28 | Professional | None | $467.74 | $724.44 | $3,162.28 |
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 $467.74 Median $645.65 Typical High $1,122.02 | Professional | None | $467.74 | $645.65 | $1,122.02 |
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 $295.12 Median $331.13 Typical High $354.81 | Professional | 52 · Reduced service | $295.12 | $331.13 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $117.49 Median $131.83 Typical High $144.54 | Professional | 53 · Discontinued | $117.49 | $131.83 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $501.19 Typical High $537.03 | Professional | 54 · Surgery only | $446.68 | $501.19 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $100.00 Typical High $107.15 | Professional | 55 · Aftercare only | $89.13 | $100.00 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $66.07 Typical High $72.44 | Professional | 56 · Pre-op care only | $58.88 | $66.07 | $72.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $467.74 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $416.87 | $467.74 | $501.19 |
Where Virginia sits
The same service costs 7.2 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
$708
AK $2,630TX $363
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.