How much rates vary
Facilitymedian $776 · 10th to 90th $178 to $4,074Professionalmedian $288 · 10th to 90th $200 to $447
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 $346.74 Median $4,073.80 Typical High $9,332.54 | Facility | None | $346.74 | $4,073.80 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $234.42 Median $331.13 Typical High $389.05 | Professional | None | $234.42 | $331.13 | $389.05 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,698.24 Median $2,398.83 Typical High $2,951.21 | Facility | None | $1,698.24 | $2,398.83 | $2,951.21 |
Anthem BCBS Setting Professional Modifier None Typical Low $194.98 Median $275.42 Typical High $389.05 | Professional | None | $194.98 | $275.42 | $389.05 |
CareFirst Setting Professional Modifier None Typical Low $190.55 Median $213.80 Typical High $2,511.89 | Professional | None | $190.55 | $213.80 | $2,511.89 |
Cigna Setting Facility Modifier None Typical Low $302.00 Median $549.54 Typical High $2,187.76 | Facility | None | $302.00 | $549.54 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $302.00 Typical High $446.68 | Professional | None | $204.17 | $302.00 | $446.68 |
Kaiser Permanente Setting Professional Modifier None Typical Low $186.21 Median $363.08 Typical High $446.68 | Professional | None | $186.21 | $363.08 | $446.68 |
Medcost Setting Professional Modifier None Typical Low $331.13 Median $416.87 Typical High $416.87 | Professional | None | $331.13 | $416.87 | $416.87 |
Medcost Setting Facility Modifier None Typical Low $245.47 Median $346.74 Typical High $562.34 | Facility | None | $245.47 | $346.74 | $562.34 |
Medcost Setting Professional Modifier None Typical Low $371.54 Median $371.54 Typical High $371.54 | Professional | None | $371.54 | $371.54 | $371.54 |
Sentara Setting Facility Modifier None Typical Low $199.53 Median $426.58 Typical High $2,454.71 | Facility | None | $199.53 | $426.58 | $2,454.71 |
Sentara Setting Professional Modifier None Typical Low $223.87 Median $389.05 Typical High $1,174.90 | Professional | None | $223.87 | $389.05 | $1,174.90 |
United Setting Facility Modifier None Typical Low $100.00 Median $660.69 Typical High $2,089.30 | Facility | None | $100.00 | $660.69 | $2,089.30 |
United Setting Professional Modifier None Typical Low $181.97 Median $323.59 Typical High $524.81 | Professional | None | $181.97 | $323.59 | $524.81 |
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 $117.49 Median $138.04 Typical High $173.78 | Professional | 52 · Reduced service | $117.49 | $138.04 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $46.77 Median $54.95 Typical High $70.79 | Professional | 53 · Discontinued | $46.77 | $54.95 | $70.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $173.78 Median $204.17 Typical High $263.03 | Professional | 54 · Surgery only | $173.78 | $204.17 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $41.69 Typical High $52.48 | Professional | 55 · Aftercare only | $34.67 | $41.69 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $27.54 Typical High $35.48 | Professional | 56 · Pre-op care only | $23.44 | $27.54 | $35.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $162.18 Median $190.55 Typical High $245.47 | Professional | 78 · Unplanned return to OR | $162.18 | $190.55 | $245.47 |
Where Virginia sits
The same service costs 3.7 times more in Wisconsin 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
$302
WI $891UT $240
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.