How much rates vary
Facilitymedian $3,090 · 10th to 90th $977 to $13,183Professionalmedian $1,380 · 10th to 90th $1,096 to $2,291
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 $1,174.90 Median $1,479.11 Typical High $1,819.70 | Facility | None | $1,174.90 | $1,479.11 | $1,819.70 |
Aetna Setting Professional Modifier None Typical Low $1,174.90 Median $1,513.56 Typical High $1,819.70 | Professional | None | $1,174.90 | $1,513.56 | $1,819.70 |
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 $1,096.48 Median $1,288.25 Typical High $1,584.89 | Professional | None | $1,096.48 | $1,288.25 | $1,584.89 |
CareFirst Setting Professional Modifier None Typical Low $1,148.15 Median $1,288.25 Typical High $1,548.82 | Professional | None | $1,148.15 | $1,288.25 | $1,548.82 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $831.76 Typical High $2,691.53 | Facility | None | $512.86 | $831.76 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $1,148.15 Median $1,513.56 Typical High $2,290.87 | Professional | None | $1,148.15 | $1,513.56 | $2,290.87 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,479.11 Median $1,778.28 Typical High $2,187.76 | Professional | None | $1,479.11 | $1,778.28 | $2,187.76 |
Medcost Setting Professional Modifier None Typical Low $2,344.23 Median $2,951.21 Typical High $2,951.21 | Professional | None | $2,344.23 | $2,951.21 | $2,951.21 |
Medcost Setting Facility Modifier None Typical Low $1,513.56 Median $1,862.09 Typical High $2,951.21 | Facility | None | $1,513.56 | $1,862.09 | $2,951.21 |
Medcost Setting Professional Modifier None Typical Low $1,995.26 Median $2,290.87 Typical High $2,290.87 | Professional | None | $1,995.26 | $2,290.87 | $2,290.87 |
Sentara Setting Facility Modifier None Typical Low $1,023.29 Median $2,570.40 Typical High $10,232.93 | Facility | None | $1,023.29 | $2,570.40 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $1,479.11 Median $1,995.26 Typical High $3,630.78 | Professional | None | $1,479.11 | $1,995.26 | $3,630.78 |
United Setting Facility Modifier None Typical Low $1,995.26 Median $8,511.38 Typical High $20,417.38 | Facility | None | $1,995.26 | $8,511.38 | $20,417.38 |
United Setting Professional Modifier None Typical Low $933.25 Median $1,348.96 Typical High $2,754.23 | Professional | None | $933.25 | $1,348.96 | $2,754.23 |
5 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 $588.84 Median $758.58 Typical High $912.01 | Professional | 52 · Reduced service | $588.84 | $758.58 | $912.01 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $302.00 Typical High $363.08 | Professional | 53 · Discontinued | $234.42 | $302.00 | $363.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $229.09 Typical High $275.42 | Professional | 55 · Aftercare only | $177.83 | $229.09 | $275.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $151.36 Typical High $181.97 | Professional | 56 · Pre-op care only | $117.49 | $151.36 | $181.97 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $1,071.52 Typical High $1,288.25 | Professional | 78 · Unplanned return to OR | $831.76 | $1,071.52 | $1,288.25 |
Where Virginia sits
The same service costs 5.1 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· 41st of 51
$1,413
AK $4,677TX $912
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.