How much rates vary
Facilitymedian $2,138 · 10th to 90th $631 to $6,918Professionalmedian $724 · 10th to 90th $589 to $1,047
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 $724.44 Median $5,370.32 Typical High $14,125.38 | Facility | None | $724.44 | $5,370.32 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $691.83 Median $724.44 Typical High $1,096.48 | Professional | None | $691.83 | $724.44 | $1,096.48 |
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 $630.96 Median $758.58 Typical High $912.01 | Professional | None | $630.96 | $758.58 | $912.01 |
CareFirst Setting Professional Modifier None Typical Low $676.08 Median $758.58 Typical High $977.24 | Professional | None | $676.08 | $758.58 | $977.24 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $1,698.24 Typical High $3,090.30 | Facility | None | $524.81 | $1,698.24 | $3,090.30 |
Cigna Setting Professional Modifier None Typical Low $588.84 Median $676.08 Typical High $1,047.13 | Professional | None | $588.84 | $676.08 | $1,047.13 |
Kaiser Permanente Setting Professional Modifier None Typical Low $630.96 Median $758.58 Typical High $954.99 | Professional | None | $630.96 | $758.58 | $954.99 |
Medcost Setting Professional Modifier None Typical Low $870.96 Median $1,096.48 Typical High $1,096.48 | Professional | None | $870.96 | $1,096.48 | $1,096.48 |
Medcost Setting Facility Modifier None Typical Low $691.83 Median $794.33 Typical High $1,122.02 | Facility | None | $691.83 | $794.33 | $1,122.02 |
Medcost Setting Professional Modifier None Typical Low $588.84 Median $741.31 Typical High $933.25 | Professional | None | $588.84 | $741.31 | $933.25 |
Sentara Setting Facility Modifier None Typical Low $616.60 Median $1,174.90 Typical High $3,630.78 | Facility | None | $616.60 | $1,174.90 | $3,630.78 |
Sentara Setting Professional Modifier None Typical Low $616.60 Median $758.58 Typical High $1,584.89 | Professional | None | $616.60 | $758.58 | $1,584.89 |
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 $446.68 Median $616.60 Typical High $1,174.90 | Professional | None | $446.68 | $616.60 | $1,174.90 |
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 $346.74 Median $346.74 Typical High $363.08 | Professional | 52 · Reduced service | $346.74 | $346.74 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $138.04 Typical High $144.54 | Professional | 53 · Discontinued | $138.04 | $138.04 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $512.86 Typical High $549.54 | Professional | 54 · Surgery only | $512.86 | $512.86 | $549.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $102.33 Typical High $109.65 | Professional | 55 · Aftercare only | $102.33 | $102.33 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $69.18 Typical High $72.44 | Professional | 56 · Pre-op care only | $69.18 | $69.18 | $72.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $478.63 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $478.63 | $478.63 | $512.86 |
Where Virginia sits
The same service costs 4.3 times more in Alaska than in West Virginia. 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.
Physician feeFacility fee
AK $6,645WV $1,559
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.