How much rates vary
Facilitymedian $2,089 · 10th to 90th $661 to $7,762Professionalmedian $741 · 10th to 90th $589 to $1,148
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 $851.14 Median $7,079.46 Typical High $15,488.17 | Facility | None | $851.14 | $7,079.46 | $15,488.17 |
Aetna Setting Professional Modifier None Typical Low $676.08 Median $851.14 Typical High $870.96 | Professional | None | $676.08 | $851.14 | $870.96 |
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 $602.56 Median $724.44 Typical High $870.96 | Professional | None | $602.56 | $724.44 | $870.96 |
CareFirst Setting Professional Modifier None Typical Low $630.96 Median $691.83 Typical High $812.83 | Professional | None | $630.96 | $691.83 | $812.83 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $1,096.48 Typical High $3,019.95 | Facility | None | $676.08 | $1,096.48 | $3,019.95 |
Cigna Setting Professional Modifier None Typical Low $630.96 Median $794.33 Typical High $1,202.26 | Professional | None | $630.96 | $794.33 | $1,202.26 |
Kaiser Permanente Setting Professional Modifier None Typical Low $776.25 Median $933.25 Typical High $1,174.90 | Professional | None | $776.25 | $933.25 | $1,174.90 |
Medcost Setting Professional Modifier None Typical Low $933.25 Median $1,148.15 Typical High $1,148.15 | Professional | None | $933.25 | $1,148.15 | $1,148.15 |
Medcost Setting Facility Modifier None Typical Low $707.95 Median $870.96 Typical High $1,412.54 | Facility | None | $707.95 | $870.96 | $1,412.54 |
Medcost Setting Professional Modifier None Typical Low $912.01 Median $977.24 Typical High $1,949.84 | Professional | None | $912.01 | $977.24 | $1,949.84 |
Sentara Setting Facility Modifier None Typical Low $588.84 Median $1,174.90 Typical High $3,715.35 | Facility | None | $588.84 | $1,174.90 | $3,715.35 |
Sentara Setting Professional Modifier None Typical Low $758.58 Median $933.25 Typical High $1,862.09 | Professional | None | $758.58 | $933.25 | $1,862.09 |
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 $478.63 Median $691.83 Typical High $1,348.96 | Professional | None | $478.63 | $691.83 | $1,348.96 |
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 $331.13 Median $398.11 Typical High $436.52 | Professional | 52 · Reduced service | $331.13 | $398.11 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $158.49 Typical High $173.78 | Professional | 53 · Discontinued | $134.90 | $158.49 | $173.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $588.84 Typical High $645.65 | Professional | 54 · Surgery only | $501.19 | $588.84 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $117.49 Typical High $131.83 | Professional | 55 · Aftercare only | $100.00 | $117.49 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $79.43 Typical High $87.10 | Professional | 56 · Pre-op care only | $67.61 | $79.43 | $87.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $549.54 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $467.74 | $549.54 | $602.56 |
Where Virginia sits
The same service costs 5.6 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· 39th of 51
$759
AK $2,630TX $468
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.