How much rates vary
Facilitymedian $513 · 10th to 90th $138 to $3,388Professionalmedian $324 · 10th to 90th $240 to $479
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 $316.23 Median $3,981.07 Typical High $14,125.38 | Facility | None | $316.23 | $3,981.07 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $309.03 Median $331.13 Typical High $524.81 | Professional | None | $309.03 | $331.13 | $524.81 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,698.24 Median $2,398.83 Typical High $2,951.21 | Facility | None | $1,698.24 | $2,398.83 | $2,951.21 |
Anthem BCBS Setting Professional Modifier None Typical Low $281.84 Median $338.84 Typical High $407.38 | Professional | None | $281.84 | $338.84 | $407.38 |
CareFirst Setting Professional Modifier None Typical Low $323.59 Median $354.81 Typical High $426.58 | Professional | None | $323.59 | $354.81 | $426.58 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $141.25 Typical High $263.03 | Facility | None | $50.12 | $141.25 | $263.03 |
Cigna Setting Professional Modifier None Typical Low $263.03 Median $309.03 Typical High $478.63 | Professional | None | $263.03 | $309.03 | $478.63 |
Kaiser Permanente Setting Professional Modifier None Typical Low $331.13 Median $398.11 Typical High $512.86 | Professional | None | $331.13 | $398.11 | $512.86 |
Medcost Setting Professional Modifier None Typical Low $281.84 Median $354.81 Typical High $354.81 | Professional | None | $281.84 | $354.81 | $354.81 |
Medcost Setting Facility Modifier None Typical Low $309.03 Median $331.13 Typical High $537.03 | Facility | None | $309.03 | $331.13 | $537.03 |
Medcost Setting Professional Modifier None Typical Low $177.83 Median $199.53 Typical High $323.59 | Professional | None | $177.83 | $199.53 | $323.59 |
Sentara Setting Facility Modifier None Typical Low $223.87 Median $436.52 Typical High $2,454.71 | Facility | None | $223.87 | $436.52 | $2,454.71 |
Sentara Setting Professional Modifier None Typical Low $223.87 Median $331.13 Typical High $724.44 | Professional | None | $223.87 | $331.13 | $724.44 |
United Setting Facility Modifier None Typical Low $100.00 Median $660.69 Typical High $2,041.74 | Facility | None | $100.00 | $660.69 | $2,041.74 |
United Setting Professional Modifier None Typical Low $194.98 Median $263.03 Typical High $524.81 | Professional | None | $194.98 | $263.03 | $524.81 |
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 $154.88 Median $158.49 Typical High $165.96 | Professional | 52 · Reduced service | $154.88 | $158.49 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $63.10 Typical High $66.07 | Professional | 53 · Discontinued | $61.66 | $63.10 | $66.07 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $234.42 Median $234.42 Typical High $251.19 | Professional | 54 · Surgery only | $234.42 | $234.42 | $251.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $46.77 Typical High $50.12 | Professional | 55 · Aftercare only | $46.77 | $46.77 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $31.62 Typical High $33.11 | Professional | 56 · Pre-op care only | $30.90 | $31.62 | $33.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $218.78 Median $218.78 Typical High $234.42 | Professional | 78 · Unplanned return to OR | $218.78 | $218.78 | $234.42 |
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· 34th of 51
$324
AK $1,230TX $219
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.