How much rates vary
Facilitymedian $5,623 · 10th to 90th $1,230 to $13,490Professionalmedian $1,514 · 10th to 90th $1,202 to $2,344
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 $1,659.59 Median $6,165.95 Typical High $11,481.54 | Facility | None | $1,659.59 | $6,165.95 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $1,318.26 Median $1,479.11 Typical High $4,365.16 | Professional | None | $1,318.26 | $1,479.11 | $4,365.16 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,165.95 Median $7,413.10 Typical High $9,549.93 | Facility | None | $6,165.95 | $7,413.10 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,258.93 Median $1,513.56 Typical High $1,905.46 | Professional | None | $1,258.93 | $1,513.56 | $1,905.46 |
CareFirst Setting Professional Modifier None Typical Low $1,288.25 Median $1,412.54 Typical High $6,918.31 | Professional | None | $1,288.25 | $1,412.54 | $6,918.31 |
Cigna Setting Facility Modifier None Typical Low $724.44 Median $3,019.95 Typical High $5,754.40 | Facility | None | $724.44 | $3,019.95 | $5,754.40 |
Cigna Setting Professional Modifier None Typical Low $1,230.27 Median $1,445.44 Typical High $2,187.76 | Professional | None | $1,230.27 | $1,445.44 | $2,187.76 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,258.93 Median $1,513.56 Typical High $1,862.09 | Professional | None | $1,258.93 | $1,513.56 | $1,862.09 |
Medcost Setting Professional Modifier None Typical Low $1,548.82 Median $1,949.84 Typical High $1,949.84 | Professional | None | $1,548.82 | $1,949.84 | $1,949.84 |
Medcost Setting Facility Modifier None Typical Low $1,318.26 Median $1,548.82 Typical High $2,137.96 | Facility | None | $1,318.26 | $1,548.82 | $2,137.96 |
Medcost Setting Professional Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $1,445.44 | Professional | None | $1,445.44 | $1,445.44 | $1,445.44 |
Sentara Setting Facility Modifier None Typical Low $912.01 Median $2,570.40 Typical High $10,232.93 | Facility | None | $912.01 | $2,570.40 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $1,000.00 Median $1,584.89 Typical High $7,413.10 | Professional | None | $1,000.00 | $1,584.89 | $7,413.10 |
United Setting Facility Modifier None Typical Low $1,995.26 Median $8,511.38 Typical High $20,417.38 | Facility | None | $1,995.26 | $8,511.38 | $20,417.38 |
United Setting Professional Modifier None Typical Low $1,000.00 Median $1,659.59 Typical High $2,511.89 | Professional | None | $1,000.00 | $1,659.59 | $2,511.89 |
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 $660.69 Median $660.69 Typical High $831.76 | Professional | 52 · Reduced service | $660.69 | $660.69 | $831.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $263.03 Typical High $331.13 | Professional | 53 · Discontinued | $263.03 | $263.03 | $331.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,000.00 Typical High $1,258.93 | Professional | 54 · Surgery only | $1,000.00 | $1,000.00 | $1,258.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $199.53 Typical High $251.19 | Professional | 55 · Aftercare only | $199.53 | $199.53 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $131.83 Typical High $165.96 | Professional | 56 · Pre-op care only | $131.83 | $131.83 | $165.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $933.25 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $933.25 | $933.25 | $1,174.90 |
Where Virginia sits
The same service costs 5.9 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· 39th of 51
$1,585
AK $5,495UT $933
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.