How much rates vary
Facilitymedian $3,311 · 10th to 90th $617 to $10,000Professionalmedian $575 · 10th to 90th $457 to $933
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 $676.08 Median $5,495.41 Typical High $10,964.78 | Facility | None | $676.08 | $5,495.41 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $489.78 Median $676.08 Typical High $758.58 | Professional | None | $489.78 | $676.08 | $758.58 |
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 $457.09 Median $549.54 Typical High $660.69 | Professional | None | $457.09 | $549.54 | $660.69 |
CareFirst Setting Professional Modifier None Typical Low $501.19 Median $549.54 Typical High $724.44 | Professional | None | $501.19 | $549.54 | $724.44 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $1,698.24 Typical High $3,235.94 | Facility | None | $645.65 | $1,698.24 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $478.63 Median $645.65 Typical High $977.24 | Professional | None | $478.63 | $645.65 | $977.24 |
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 $812.83 Median $1,023.29 Typical High $1,023.29 | Professional | None | $812.83 | $1,023.29 | $1,023.29 |
Medcost Setting Facility Modifier None Typical Low $562.34 Median $758.58 Typical High $1,230.27 | Facility | None | $562.34 | $758.58 | $1,230.27 |
Medcost Setting Professional Modifier None Typical Low $831.76 Median $933.25 Typical High $977.24 | Professional | None | $831.76 | $933.25 | $977.24 |
Sentara Setting Facility Modifier None Typical Low $489.78 Median $1,737.80 Typical High $8,709.64 | Facility | None | $489.78 | $1,737.80 | $8,709.64 |
Sentara Setting Professional Modifier None Typical Low $549.54 Median $794.33 Typical High $1,584.89 | Professional | None | $549.54 | $794.33 | $1,584.89 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $5,011.87 Typical High $13,182.57 | Facility | None | $1,230.27 | $5,011.87 | $13,182.57 |
United Setting Professional Modifier None Typical Low $380.19 Median $588.84 Typical High $1,122.02 | Professional | None | $380.19 | $588.84 | $1,122.02 |
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 $245.47 Median $316.23 Typical High $380.19 | Professional | 52 · Reduced service | $245.47 | $316.23 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $125.89 Typical High $151.36 | Professional | 53 · Discontinued | $97.72 | $125.89 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $467.74 Typical High $575.44 | Professional | 54 · Surgery only | $371.54 | $467.74 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $93.33 Typical High $114.82 | Professional | 55 · Aftercare only | $74.13 | $93.33 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $63.10 Typical High $75.86 | Professional | 56 · Pre-op care only | $48.98 | $63.10 | $75.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $346.74 Median $436.52 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $346.74 | $436.52 | $537.03 |
Where Virginia sits
The same service costs 5.8 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· 47th of 51
$589
AK $2,455TX $427
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.