How much rates vary
Facilitymedian $2,692 · 10th to 90th $355 to $9,550Professionalmedian $316 · 10th to 90th $257 to $490
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 $323.59 Median $4,786.30 Typical High $9,332.54 | Facility | None | $323.59 | $4,786.30 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $288.40 Median $323.59 Typical High $489.78 | Professional | None | $288.40 | $323.59 | $489.78 |
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 $263.03 Median $316.23 Typical High $380.19 | Professional | None | $263.03 | $316.23 | $380.19 |
CareFirst Setting Professional Modifier None Typical Low $281.84 Median $309.03 Typical High $407.38 | Professional | None | $281.84 | $309.03 | $407.38 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $1,023.29 Typical High $2,570.40 | Facility | None | $524.81 | $1,023.29 | $2,570.40 |
Cigna Setting Professional Modifier None Typical Low $275.42 Median $316.23 Typical High $501.19 | Professional | None | $275.42 | $316.23 | $501.19 |
Kaiser Permanente Setting Professional Modifier None Typical Low $316.23 Median $380.19 Typical High $467.74 | Professional | None | $316.23 | $380.19 | $467.74 |
Medcost Setting Professional Modifier None Typical Low $407.38 Median $512.86 Typical High $691.83 | Professional | None | $407.38 | $512.86 | $691.83 |
Medcost Setting Facility Modifier None Typical Low $316.23 Median $398.11 Typical High $588.84 | Facility | None | $316.23 | $398.11 | $588.84 |
Medcost Setting Professional Modifier None Typical Low $251.19 Median $302.00 Typical High $398.11 | Professional | None | $251.19 | $302.00 | $398.11 |
Sentara Setting Facility Modifier None Typical Low $288.40 Median $1,288.25 Typical High $8,709.64 | Facility | None | $288.40 | $1,288.25 | $8,709.64 |
Sentara Setting Professional Modifier None Typical Low $316.23 Median $407.38 Typical High $776.25 | Professional | None | $316.23 | $407.38 | $776.25 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $4,897.79 Typical High $13,182.57 | Facility | None | $1,230.27 | $4,897.79 | $13,182.57 |
United Setting Professional Modifier None Typical Low $204.17 Median $281.84 Typical High $575.44 | Professional | None | $204.17 | $281.84 | $575.44 |
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 $144.54 Median $158.49 Typical High $177.83 | Professional | 52 · Reduced service | $144.54 | $158.49 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $57.54 Median $64.57 Typical High $72.44 | Professional | 53 · Discontinued | $57.54 | $64.57 | $72.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $213.80 Median $239.88 Typical High $269.15 | Professional | 54 · Surgery only | $213.80 | $239.88 | $269.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $47.86 Typical High $53.70 | Professional | 55 · Aftercare only | $42.66 | $47.86 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.84 Median $31.62 Typical High $35.48 | Professional | 56 · Pre-op care only | $28.84 | $31.62 | $35.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $199.53 Median $223.87 Typical High $251.19 | Professional | 78 · Unplanned return to OR | $199.53 | $223.87 | $251.19 |
Where Virginia sits
The same service costs 6.8 times more in Alaska than in Utah. 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· 38th of 51
$324
AK $1,288UT $191
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.