How much rates vary
Facilitymedian $2,951 · 10th to 90th $380 to $9,550Professionalmedian $380 · 10th to 90th $282 to $589
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 $436.52 Median $4,073.80 Typical High $9,332.54 | Facility | None | $436.52 | $4,073.80 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $338.84 Median $436.52 Typical High $588.84 | Professional | None | $338.84 | $436.52 | $588.84 |
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 $275.42 Median $371.54 Typical High $489.78 | Professional | None | $275.42 | $371.54 | $489.78 |
CareFirst Setting Professional Modifier None Typical Low $269.15 Median $302.00 Typical High $4,365.16 | Professional | None | $269.15 | $302.00 | $4,365.16 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $1,513.56 Typical High $2,818.38 | Facility | None | $478.63 | $1,513.56 | $2,818.38 |
Cigna Setting Professional Modifier None Typical Low $288.40 Median $380.19 Typical High $575.44 | Professional | None | $288.40 | $380.19 | $575.44 |
Kaiser Permanente Setting Professional Modifier None Typical Low $257.04 Median $446.68 Typical High $549.54 | Professional | None | $257.04 | $446.68 | $549.54 |
Medcost Setting Professional Modifier None Typical Low $426.58 Median $537.03 Typical High $537.03 | Professional | None | $426.58 | $537.03 | $537.03 |
Medcost Setting Facility Modifier None Typical Low $338.84 Median $436.52 Typical High $707.95 | Facility | None | $338.84 | $436.52 | $707.95 |
Medcost Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $457.09 | Professional | None | $457.09 | $457.09 | $457.09 |
Sentara Setting Facility Modifier None Typical Low $275.42 Median $1,318.26 Typical High $8,709.64 | Facility | None | $275.42 | $1,318.26 | $8,709.64 |
Sentara Setting Professional Modifier None Typical Low $338.84 Median $489.78 Typical High $4,073.80 | Professional | None | $338.84 | $489.78 | $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 $251.19 Median $426.58 Typical High $691.83 | Professional | None | $251.19 | $426.58 | $691.83 |
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 $169.82 Median $177.83 Typical High $223.87 | Professional | 52 · Reduced service | $169.82 | $177.83 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $70.79 Typical High $91.20 | Professional | 53 · Discontinued | $67.61 | $70.79 | $91.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $269.15 Typical High $338.84 | Professional | 54 · Surgery only | $251.19 | $269.15 | $338.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $53.70 Typical High $67.61 | Professional | 55 · Aftercare only | $50.12 | $53.70 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $35.48 Typical High $45.71 | Professional | 56 · Pre-op care only | $33.88 | $35.48 | $45.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $234.42 Median $251.19 Typical High $316.23 | Professional | 78 · Unplanned return to OR | $234.42 | $251.19 | $316.23 |
Where Virginia sits
The same service costs 4.9 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· 45th of 51
$398
AK $1,479UT $302
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.