How much rates vary
Facilitymedian $692 · 10th to 90th $178 to $3,981Professionalmedian $295 · 10th to 90th $200 to $479
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 $363.08 Median $3,981.07 Typical High $9,332.54 | Facility | None | $363.08 | $3,981.07 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $239.88 Median $338.84 Typical High $389.05 | Professional | None | $239.88 | $338.84 | $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 $199.53 Median $275.42 Typical High $389.05 | Professional | None | $199.53 | $275.42 | $389.05 |
CareFirst Setting Professional Modifier None Typical Low $194.98 Median $213.80 Typical High $776.25 | Professional | None | $194.98 | $213.80 | $776.25 |
Cigna Setting Facility Modifier None Typical Low $302.00 Median $478.63 Typical High $1,621.81 | Facility | None | $302.00 | $478.63 | $1,621.81 |
Cigna Setting Professional Modifier None Typical Low $208.93 Median $302.00 Typical High $467.74 | Professional | None | $208.93 | $302.00 | $467.74 |
Kaiser Permanente Setting Professional Modifier None Typical Low $190.55 Median $363.08 Typical High $457.09 | Professional | None | $190.55 | $363.08 | $457.09 |
Medcost Setting Professional Modifier None Typical Low $354.81 Median $446.68 Typical High $446.68 | Professional | None | $354.81 | $446.68 | $446.68 |
Medcost Setting Facility Modifier None Typical Low $257.04 Median $389.05 Typical High $630.96 | Facility | None | $257.04 | $389.05 | $630.96 |
Medcost Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $389.05 | Professional | None | $389.05 | $389.05 | $389.05 |
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 $245.47 Median $426.58 Typical High $1,174.90 | Professional | None | $245.47 | $426.58 | $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 $199.53 Median $346.74 Typical High $616.60 | Professional | None | $199.53 | $346.74 | $616.60 |
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 $120.23 Median $147.91 Typical High $194.98 | Professional | 52 · Reduced service | $120.23 | $147.91 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $58.88 Typical High $77.62 | Professional | 53 · Discontinued | $47.86 | $58.88 | $77.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $223.87 Typical High $295.12 | Professional | 54 · Surgery only | $177.83 | $223.87 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $44.67 Typical High $58.88 | Professional | 55 · Aftercare only | $35.48 | $44.67 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $29.51 Typical High $38.90 | Professional | 56 · Pre-op care only | $23.99 | $29.51 | $38.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $165.96 Median $208.93 Typical High $275.42 | Professional | 78 · Unplanned return to OR | $165.96 | $208.93 | $275.42 |
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· 44th of 51
$309
WI $933TX $251
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.