How much rates vary
Facilitymedian $3,548 · 10th to 90th $575 to $9,550Professionalmedian $575 · 10th to 90th $490 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 $575.44 Median $5,370.32 Typical High $10,000.00 | Facility | None | $575.44 | $5,370.32 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $524.81 Median $575.44 Typical High $3,981.07 | Professional | None | $524.81 | $575.44 | $3,981.07 |
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 $489.78 Median $588.84 Typical High $758.58 | Professional | None | $489.78 | $588.84 | $758.58 |
CareFirst Setting Professional Modifier None Typical Low $501.19 Median $549.54 Typical High $3,890.45 | Professional | None | $501.19 | $549.54 | $3,890.45 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $1,659.59 Typical High $3,019.95 | Facility | None | $524.81 | $1,659.59 | $3,019.95 |
Cigna Setting Professional Modifier None Typical Low $501.19 Median $562.34 Typical High $891.25 | Professional | None | $501.19 | $562.34 | $891.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $501.19 Median $588.84 Typical High $741.31 | Professional | None | $501.19 | $588.84 | $741.31 |
Medcost Setting Professional Modifier None Typical Low $602.56 Median $758.58 Typical High $758.58 | Professional | None | $602.56 | $758.58 | $758.58 |
Medcost Setting Facility Modifier None Typical Low $575.44 Median $616.60 Typical High $933.25 | Facility | None | $575.44 | $616.60 | $933.25 |
Medcost Setting Professional Modifier None Typical Low $602.56 Median $602.56 Typical High $602.56 | Professional | None | $602.56 | $602.56 | $602.56 |
Sentara Setting Facility Modifier None Typical Low $436.52 Median $1,737.80 Typical High $8,709.64 | Facility | None | $436.52 | $1,737.80 | $8,709.64 |
Sentara Setting Professional Modifier None Typical Low $446.68 Median $645.65 Typical High $4,570.88 | Professional | None | $446.68 | $645.65 | $4,570.88 |
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 $389.05 Median $630.96 Typical High $1,000.00 | Professional | None | $389.05 | $630.96 | $1,000.00 |
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 $263.03 Median $288.40 Typical High $288.40 | Professional | 52 · Reduced service | $263.03 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $114.82 Typical High $114.82 | Professional | 53 · Discontinued | $104.71 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $436.52 Typical High $436.52 | Professional | 54 · Surgery only | $389.05 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $87.10 Typical High $87.10 | Professional | 55 · Aftercare only | $77.62 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $57.54 Typical High $57.54 | Professional | 56 · Pre-op care only | $52.48 | $57.54 | $57.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $407.38 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $363.08 | $407.38 | $407.38 |
Where Virginia sits
The same service costs 5.4 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· 41st of 51
$617
AK $2,138UT $398
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.