How much rates vary
Facilitymedian $3,715 · 10th to 90th $437 to $9,772Professionalmedian $427 · 10th to 90th $309 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 $524.81 Median $4,073.80 Typical High $9,332.54 | Facility | None | $524.81 | $4,073.80 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $389.05 Median $467.74 Typical High $549.54 | Professional | None | $389.05 | $467.74 | $549.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,165.95 Median $7,413.10 Typical High $9,549.93 | Facility | None | $6,165.95 | $7,413.10 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $309.03 Median $426.58 Typical High $549.54 | Professional | None | $309.03 | $426.58 | $549.54 |
CareFirst Setting Professional Modifier None Typical Low $309.03 Median $346.74 Typical High $407.38 | Professional | None | $309.03 | $346.74 | $407.38 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $2,691.53 Typical High $5,754.40 | Facility | None | $478.63 | $2,691.53 | $5,754.40 |
Cigna Setting Professional Modifier None Typical Low $323.59 Median $436.52 Typical High $616.60 | Professional | None | $323.59 | $436.52 | $616.60 |
Kaiser Permanente Setting Professional Modifier None Typical Low $457.09 Median $537.03 Typical High $776.25 | Professional | None | $457.09 | $537.03 | $776.25 |
Medcost Setting Professional Modifier None Typical Low $512.86 Median $645.65 Typical High $645.65 | Professional | None | $512.86 | $645.65 | $645.65 |
Medcost Setting Facility Modifier None Typical Low $389.05 Median $524.81 Typical High $851.14 | Facility | None | $389.05 | $524.81 | $851.14 |
Medcost Setting Professional Modifier None Typical Low $457.09 Median $478.63 Typical High $741.31 | Professional | None | $457.09 | $478.63 | $741.31 |
Sentara Setting Facility Modifier None Typical Low $316.23 Median $1,445.44 Typical High $9,332.54 | Facility | None | $316.23 | $1,445.44 | $9,332.54 |
Sentara Setting Professional Modifier None Typical Low $354.81 Median $501.19 Typical High $794.33 | Professional | None | $354.81 | $501.19 | $794.33 |
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 $275.42 Median $416.87 Typical High $691.83 | Professional | None | $275.42 | $416.87 | $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 $194.98 Median $213.80 Typical High $275.42 | Professional | 52 · Reduced service | $194.98 | $213.80 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $77.62 Median $85.11 Typical High $109.65 | Professional | 53 · Discontinued | $77.62 | $85.11 | $109.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $288.40 Median $323.59 Typical High $407.38 | Professional | 54 · Surgery only | $288.40 | $323.59 | $407.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $64.57 Typical High $81.28 | Professional | 55 · Aftercare only | $58.88 | $64.57 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $42.66 Typical High $54.95 | Professional | 56 · Pre-op care only | $38.90 | $42.66 | $54.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $269.15 Median $302.00 Typical High $380.19 | Professional | 78 · Unplanned return to OR | $269.15 | $302.00 | $380.19 |
Where Virginia sits
The same service costs 4.0 times more in Alaska than in New Jersey. 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
$427
AK $1,318NJ $331
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.