How much rates vary
Facilitymedian $692 · 10th to 90th $195 to $4,074Professionalmedian $339 · 10th to 90th $263 to $501
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 $309.03 Median $4,073.80 Typical High $10,000.00 | Facility | None | $309.03 | $4,073.80 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $281.84 Median $354.81 Typical High $616.60 | Professional | None | $281.84 | $354.81 | $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 $263.03 Median $338.84 Typical High $446.68 | Professional | None | $263.03 | $338.84 | $446.68 |
CareFirst Setting Professional Modifier None Typical Low $281.84 Median $316.23 Typical High $363.08 | Professional | None | $281.84 | $316.23 | $363.08 |
Cigna Setting Facility Modifier None Typical Low $208.93 Median $389.05 Typical High $1,621.81 | Facility | None | $208.93 | $389.05 | $1,621.81 |
Cigna Setting Professional Modifier None Typical Low $269.15 Median $338.84 Typical High $478.63 | Professional | None | $269.15 | $338.84 | $478.63 |
Kaiser Permanente Setting Professional Modifier None Typical Low $309.03 Median $407.38 Typical High $478.63 | Professional | None | $309.03 | $407.38 | $478.63 |
Medcost Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $588.84 | Professional | None | $512.86 | $512.86 | $588.84 |
Medcost Setting Facility Modifier None Typical Low $309.03 Median $380.19 Typical High $630.96 | Facility | None | $309.03 | $380.19 | $630.96 |
Medcost Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $831.76 | Professional | None | $831.76 | $831.76 | $831.76 |
Sentara Setting Facility Modifier None Typical Low $251.19 Median $478.63 Typical High $2,454.71 | Facility | None | $251.19 | $478.63 | $2,454.71 |
Sentara Setting Professional Modifier None Typical Low $288.40 Median $416.87 Typical High $1,258.93 | Professional | None | $288.40 | $416.87 | $1,258.93 |
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 $229.09 Median $346.74 Typical High $575.44 | Professional | None | $229.09 | $346.74 | $575.44 |
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 $141.25 Median $154.88 Typical High $190.55 | Professional | 52 · Reduced service | $141.25 | $154.88 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $61.66 Typical High $75.86 | Professional | 53 · Discontinued | $56.23 | $61.66 | $75.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $234.42 Typical High $288.40 | Professional | 54 · Surgery only | $208.93 | $234.42 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $46.77 Typical High $57.54 | Professional | 55 · Aftercare only | $41.69 | $46.77 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $30.90 Typical High $38.02 | Professional | 56 · Pre-op care only | $28.18 | $30.90 | $38.02 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $194.98 Median $218.78 Typical High $269.15 | Professional | 78 · Unplanned return to OR | $194.98 | $218.78 | $269.15 |
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· 30th of 51
$347
AK $1,122TX $240
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.