How much rates vary
Facilitymedian $4,365 · 10th to 90th $457 to $13,183Professionalmedian $437 · 10th to 90th $331 to $871
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 $660.69 Median $4,073.80 Typical High $9,332.54 | Facility | None | $660.69 | $4,073.80 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $371.54 Median $630.96 Typical High $776.25 | Professional | None | $371.54 | $630.96 | $776.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,165.95 Median $7,413.10 Typical High $9,549.93 | Facility | None | $6,165.95 | $7,413.10 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $331.13 Median $398.11 Typical High $478.63 | Professional | None | $331.13 | $398.11 | $478.63 |
CareFirst Setting Professional Modifier None Typical Low $346.74 Median $380.19 Typical High $501.19 | Professional | None | $346.74 | $380.19 | $501.19 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $2,691.53 Typical High $5,754.40 | Facility | None | $478.63 | $2,691.53 | $5,754.40 |
Cigna Setting Professional Modifier None Typical Low $363.08 Median $616.60 Typical High $933.25 | Professional | None | $363.08 | $616.60 | $933.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $616.60 Median $741.31 Typical High $933.25 | Professional | None | $616.60 | $741.31 | $933.25 |
Medcost Setting Professional Modifier None Typical Low $524.81 Median $933.25 Typical High $933.25 | Professional | None | $524.81 | $933.25 | $933.25 |
Medcost Setting Facility Modifier None Typical Low $446.68 Median $724.44 Typical High $1,258.93 | Facility | None | $446.68 | $724.44 | $1,258.93 |
Medcost Setting Professional Modifier None Typical Low $218.78 Median $263.03 Typical High $851.14 | Professional | None | $218.78 | $263.03 | $851.14 |
Sentara Setting Facility Modifier None Typical Low $338.84 Median $1,659.59 Typical High $10,232.93 | Facility | None | $338.84 | $1,659.59 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $380.19 Median $812.83 Typical High $1,584.89 | Professional | None | $380.19 | $812.83 | $1,584.89 |
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 $275.42 Median $537.03 Typical High $1,096.48 | Professional | None | $275.42 | $537.03 | $1,096.48 |
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 $186.21 Median $288.40 Typical High $389.05 | Professional | 52 · Reduced service | $186.21 | $288.40 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $114.82 Typical High $154.88 | Professional | 53 · Discontinued | $74.13 | $114.82 | $154.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $426.58 Typical High $588.84 | Professional | 54 · Surgery only | $275.42 | $426.58 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $87.10 Typical High $117.49 | Professional | 55 · Aftercare only | $54.95 | $87.10 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $57.54 Typical High $77.62 | Professional | 56 · Pre-op care only | $37.15 | $57.54 | $77.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $257.04 Median $398.11 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $257.04 | $398.11 | $549.54 |
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· 47th of 51
$447
AK $1,862TX $380
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.