How much rates vary
Facilitymedian $2,188 · 10th to 90th $676 to $7,244Professionalmedian $955 · 10th to 90th $759 to $1,318
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 $954.99 Median $5,888.44 Typical High $14,125.38 | Facility | None | $954.99 | $5,888.44 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $912.01 Median $954.99 Typical High $1,318.26 | Professional | None | $912.01 | $954.99 | $1,318.26 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,677.35 Median $6,456.54 Typical High $7,244.36 | Facility | None | $4,677.35 | $6,456.54 | $7,244.36 |
Anthem BCBS Setting Professional Modifier None Typical Low $812.83 Median $977.24 Typical High $1,174.90 | Professional | None | $812.83 | $977.24 | $1,174.90 |
CareFirst Setting Professional Modifier None Typical Low $870.96 Median $954.99 Typical High $1,230.27 | Professional | None | $870.96 | $954.99 | $1,230.27 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $1,737.80 Typical High $3,235.94 | Facility | None | $645.65 | $1,737.80 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $794.33 Median $891.25 Typical High $1,318.26 | Professional | None | $794.33 | $891.25 | $1,318.26 |
Kaiser Permanente Setting Professional Modifier None Typical Low $794.33 Median $933.25 Typical High $1,174.90 | Professional | None | $794.33 | $933.25 | $1,174.90 |
Medcost Setting Professional Modifier None Typical Low $954.99 Median $1,202.26 Typical High $1,202.26 | Professional | None | $954.99 | $1,202.26 | $1,202.26 |
Medcost Setting Facility Modifier None Typical Low $954.99 Median $1,071.52 Typical High $1,584.89 | Facility | None | $954.99 | $1,071.52 | $1,584.89 |
Medcost Setting Professional Modifier None Typical Low $812.83 Median $1,023.29 Typical High $1,258.93 | Professional | None | $812.83 | $1,023.29 | $1,258.93 |
Sentara Setting Facility Modifier None Typical Low $676.08 Median $1,348.96 Typical High $4,073.80 | Facility | None | $676.08 | $1,348.96 | $4,073.80 |
Sentara Setting Professional Modifier None Typical Low $645.65 Median $977.24 Typical High $2,041.74 | Professional | None | $645.65 | $977.24 | $2,041.74 |
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 $575.44 Median $776.25 Typical High $1,548.82 | Professional | None | $575.44 | $776.25 | $1,548.82 |
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 $457.09 Median $478.63 Typical High $478.63 | Professional | 52 · Reduced service | $457.09 | $478.63 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $194.98 Typical High $194.98 | Professional | 53 · Discontinued | $181.97 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $724.44 Typical High $724.44 | Professional | 54 · Surgery only | $676.08 | $724.44 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $144.54 Typical High $144.54 | Professional | 55 · Aftercare only | $134.90 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $95.50 Typical High $95.50 | Professional | 56 · Pre-op care only | $91.20 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $676.08 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $630.96 | $676.08 | $676.08 |
Where Virginia sits
The same service costs 7.1 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· 36th of 51
$955
AK $3,548TX $501
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.