How much rates vary
Facilitymedian $3,631 · 10th to 90th $363 to $13,490Professionalmedian $407 · 10th to 90th $288 to $575
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 $4,365.16 Typical High $14,125.38 | Facility | None | $363.08 | $4,365.16 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $302.00 Median $416.87 Typical High $575.44 | Professional | None | $302.00 | $416.87 | $575.44 |
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 $295.12 Median $426.58 Typical High $575.44 | Professional | None | $295.12 | $426.58 | $575.44 |
CareFirst Setting Professional Modifier None Typical Low $309.03 Median $346.74 Typical High $398.11 | Professional | None | $309.03 | $346.74 | $398.11 |
Cigna Setting Facility Modifier None Typical Low $407.38 Median $630.96 Typical High $2,691.53 | Facility | None | $407.38 | $630.96 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $302.00 Median $407.38 Typical High $537.03 | Professional | None | $302.00 | $407.38 | $537.03 |
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 $380.19 Median $467.74 Typical High $467.74 | Professional | None | $380.19 | $467.74 | $467.74 |
Medcost Setting Facility Modifier None Typical Low $302.00 Median $436.52 Typical High $724.44 | Facility | None | $302.00 | $436.52 | $724.44 |
Medcost Setting Professional Modifier None Typical Low $275.42 Median $288.40 Typical High $436.52 | Professional | None | $275.42 | $288.40 | $436.52 |
Sentara Setting Facility Modifier None Typical Low $229.09 Median $1,348.96 Typical High $10,232.93 | Facility | None | $229.09 | $1,348.96 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $213.80 Median $436.52 Typical High $758.58 | Professional | None | $213.80 | $436.52 | $758.58 |
United Setting Facility Modifier None Typical Low $1,995.26 Median $8,511.38 Typical High $20,417.38 | Facility | None | $1,995.26 | $8,511.38 | $20,417.38 |
United Setting Professional Modifier None Typical Low $234.42 Median $354.81 Typical High $602.56 | Professional | None | $234.42 | $354.81 | $602.56 |
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 $151.36 Median $199.53 Typical High $288.40 | Professional | 52 · Reduced service | $151.36 | $199.53 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $79.43 Typical High $114.82 | Professional | 53 · Discontinued | $60.26 | $79.43 | $114.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $223.87 Median $302.00 Typical High $436.52 | Professional | 54 · Surgery only | $223.87 | $302.00 | $436.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $60.26 Typical High $87.10 | Professional | 55 · Aftercare only | $44.67 | $60.26 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $39.81 Typical High $57.54 | Professional | 56 · Pre-op care only | $30.20 | $39.81 | $57.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $208.93 Median $281.84 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $208.93 | $281.84 | $407.38 |
Where Virginia sits
The same service costs 4.3 times more in Alaska than in Kentucky. 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· 35th of 51
$407
AK $1,259KY $295
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.