How much rates vary
Facilitymedian $692 · 10th to 90th $178 to $4,074Professionalmedian $288 · 10th to 90th $200 to $457
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 $338.84 Median $4,073.80 Typical High $9,332.54 | Facility | None | $338.84 | $4,073.80 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $229.09 Median $323.59 Typical High $363.08 | Professional | None | $229.09 | $323.59 | $363.08 |
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 $269.15 Typical High $380.19 | Professional | None | $194.98 | $269.15 | $380.19 |
CareFirst Setting Professional Modifier None Typical Low $208.93 Median $234.42 Typical High $1,513.56 | Professional | None | $208.93 | $234.42 | $1,513.56 |
Cigna Setting Facility Modifier None Typical Low $194.98 Median $446.68 Typical High $2,187.76 | Facility | None | $194.98 | $446.68 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $295.12 Typical High $467.74 | Professional | None | $204.17 | $295.12 | $467.74 |
Kaiser Permanente Setting Professional Modifier None Typical Low $177.83 Median $338.84 Typical High $426.58 | Professional | None | $177.83 | $338.84 | $426.58 |
Medcost Setting Professional Modifier None Typical Low $363.08 Median $446.68 Typical High $446.68 | Professional | None | $363.08 | $446.68 | $446.68 |
Medcost Setting Facility Modifier None Typical Low $251.19 Median $346.74 Typical High $575.44 | Facility | None | $251.19 | $346.74 | $575.44 |
Medcost Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $380.19 | Professional | None | $380.19 | $380.19 | $380.19 |
Sentara Setting Facility Modifier None Typical Low $208.93 Median $436.52 Typical High $2,454.71 | Facility | None | $208.93 | $436.52 | $2,454.71 |
Sentara Setting Professional Modifier None Typical Low $257.04 Median $436.52 Typical High $1,174.90 | Professional | None | $257.04 | $436.52 | $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 $186.21 Median $331.13 Typical High $562.34 | Professional | None | $186.21 | $331.13 | $562.34 |
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 $114.82 Median $134.90 Typical High $173.78 | Professional | 52 · Reduced service | $114.82 | $134.90 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $46.77 Median $53.70 Typical High $69.18 | Professional | 53 · Discontinued | $46.77 | $53.70 | $69.18 |
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 $40.74 Typical High $52.48 | Professional | 55 · Aftercare only | $34.67 | $40.74 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $26.92 Typical High $34.67 | Professional | 56 · Pre-op care only | $22.91 | $26.92 | $34.67 |
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 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· 37th of 51
$295
WI $891TX $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.