How much rates vary
Facilitymedian $2,570 · 10th to 90th $479 to $9,550Professionalmedian $427 · 10th to 90th $339 to $692
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 $489.78 Median $2,570.40 Typical High $8,317.64 | Facility | None | $489.78 | $2,570.40 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $380.19 Median $489.78 Typical High $575.44 | Professional | None | $380.19 | $489.78 | $575.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,884.03 Median $3,715.35 Typical High $4,265.80 | Facility | None | $2,884.03 | $3,715.35 | $4,265.80 |
Anthem BCBS Setting Professional Modifier None Typical Low $338.84 Median $407.38 Typical High $489.78 | Professional | None | $338.84 | $407.38 | $489.78 |
CareFirst Setting Professional Modifier None Typical Low $363.08 Median $407.38 Typical High $524.81 | Professional | None | $363.08 | $407.38 | $524.81 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $1,513.56 Typical High $2,818.38 | Facility | None | $478.63 | $1,513.56 | $2,818.38 |
Cigna Setting Professional Modifier None Typical Low $363.08 Median $467.74 Typical High $707.95 | Professional | None | $363.08 | $467.74 | $707.95 |
Kaiser Permanente Setting Professional Modifier None Typical Low $467.74 Median $562.34 Typical High $707.95 | Professional | None | $467.74 | $562.34 | $707.95 |
Medcost Setting Professional Modifier None Typical Low $549.54 Median $691.83 Typical High $691.83 | Professional | None | $549.54 | $691.83 | $691.83 |
Medcost Setting Facility Modifier None Typical Low $457.09 Median $575.44 Typical High $933.25 | Facility | None | $457.09 | $575.44 | $933.25 |
Medcost Setting Professional Modifier None Typical Low $275.42 Median $436.52 Typical High $602.56 | Professional | None | $275.42 | $436.52 | $602.56 |
Sentara Setting Facility Modifier None Typical Low $302.00 Median $1,548.82 Typical High $10,232.93 | Facility | None | $302.00 | $1,548.82 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $302.00 Median $588.84 Typical High $1,174.90 | Professional | None | $302.00 | $588.84 | $1,174.90 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $5,011.87 Typical High $13,182.57 | Facility | None | $1,230.27 | $5,011.87 | $13,182.57 |
United Setting Professional Modifier None Typical Low $281.84 Median $436.52 Typical High $870.96 | Professional | None | $281.84 | $436.52 | $870.96 |
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 $190.55 Median $229.09 Typical High $288.40 | Professional | 52 · Reduced service | $190.55 | $229.09 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $93.33 Typical High $114.82 | Professional | 53 · Discontinued | $75.86 | $93.33 | $114.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $281.84 Median $346.74 Typical High $436.52 | Professional | 54 · Surgery only | $281.84 | $346.74 | $436.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $69.18 Typical High $87.10 | Professional | 55 · Aftercare only | $56.23 | $69.18 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $45.71 Typical High $57.54 | Professional | 56 · Pre-op care only | $38.02 | $45.71 | $57.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $263.03 Median $323.59 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $263.03 | $323.59 | $407.38 |
Where Virginia sits
The same service costs 6.0 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· 42nd of 51
$437
AK $1,778TX $295
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.