How much rates vary
Facilitymedian $3,090 · 10th to 90th $550 to $9,550Professionalmedian $562 · 10th to 90th $457 to $891
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 $549.54 Median $4,786.30 Typical High $10,000.00 | Facility | None | $549.54 | $4,786.30 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $501.19 Median $549.54 Typical High $3,467.37 | Professional | None | $501.19 | $549.54 | $3,467.37 |
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 $467.74 Median $562.34 Typical High $724.44 | Professional | None | $467.74 | $562.34 | $724.44 |
CareFirst Setting Professional Modifier None Typical Low $467.74 Median $524.81 Typical High $2,511.89 | Professional | None | $467.74 | $524.81 | $2,511.89 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $1,288.25 Typical High $2,344.23 | Facility | None | $478.63 | $1,288.25 | $2,344.23 |
Cigna Setting Professional Modifier None Typical Low $478.63 Median $537.03 Typical High $851.14 | Professional | None | $478.63 | $537.03 | $851.14 |
Kaiser Permanente Setting Professional Modifier None Typical Low $467.74 Median $562.34 Typical High $691.83 | Professional | None | $467.74 | $562.34 | $691.83 |
Medcost Setting Professional Modifier None Typical Low $575.44 Median $724.44 Typical High $724.44 | Professional | None | $575.44 | $724.44 | $724.44 |
Medcost Setting Facility Modifier None Typical Low $549.54 Median $602.56 Typical High $891.25 | Facility | None | $549.54 | $602.56 | $891.25 |
Medcost Setting Professional Modifier None Typical Low $575.44 Median $575.44 Typical High $575.44 | Professional | None | $575.44 | $575.44 | $575.44 |
Sentara Setting Facility Modifier None Typical Low $426.58 Median $1,737.80 Typical High $8,709.64 | Facility | None | $426.58 | $1,737.80 | $8,709.64 |
Sentara Setting Professional Modifier None Typical Low $426.58 Median $602.56 Typical High $4,073.80 | Professional | None | $426.58 | $602.56 | $4,073.80 |
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 $602.56 Typical High $933.25 | Professional | None | $380.19 | $602.56 | $933.25 |
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 $275.42 Typical High $275.42 | Professional | 52 · Reduced service | $245.47 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $109.65 Typical High $109.65 | Professional | 53 · Discontinued | $97.72 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $407.38 Typical High $407.38 | Professional | 54 · Surgery only | $371.54 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $81.28 Typical High $81.28 | Professional | 55 · Aftercare only | $74.13 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $54.95 Typical High $54.95 | Professional | 56 · Pre-op care only | $48.98 | $54.95 | $54.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $346.74 Median $380.19 Typical High $380.19 | Professional | 78 · Unplanned return to OR | $346.74 | $380.19 | $380.19 |
Where Virginia sits
The same service costs 5.5 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· 40th of 51
$589
AK $2,042UT $372
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.