How much rates vary
Facilitymedian $2,089 · 10th to 90th $302 to $6,918Professionalmedian $295 · 10th to 90th $214 to $407
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 $257.04 Median $338.84 Typical High $416.87 | Professional | None | $257.04 | $338.84 | $416.87 |
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 $218.78 Median $295.12 Typical High $380.19 | Professional | None | $218.78 | $295.12 | $380.19 |
CareFirst Setting Professional Modifier None Typical Low $213.80 Median $239.88 Typical High $281.84 | Professional | None | $213.80 | $239.88 | $281.84 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $831.76 Typical High $2,187.76 | Facility | None | $478.63 | $831.76 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $223.87 Median $295.12 Typical High $416.87 | Professional | None | $223.87 | $295.12 | $416.87 |
Kaiser Permanente Setting Professional Modifier None Typical Low $302.00 Median $346.74 Typical High $501.19 | Professional | None | $302.00 | $346.74 | $501.19 |
Medcost Setting Professional Modifier None Typical Low $371.54 Median $457.09 Typical High $457.09 | Professional | None | $371.54 | $457.09 | $457.09 |
Medcost Setting Facility Modifier None Typical Low $257.04 Median $338.84 Typical High $549.54 | Facility | None | $257.04 | $338.84 | $549.54 |
Medcost Setting Professional Modifier None Typical Low $245.47 Median $288.40 Typical High $389.05 | Professional | None | $245.47 | $288.40 | $389.05 |
Sentara Setting Facility Modifier None Typical Low $218.78 Median $1,023.29 Typical High $8,709.64 | Facility | None | $218.78 | $1,023.29 | $8,709.64 |
Sentara Setting Professional Modifier None Typical Low $302.00 Median $354.81 Typical High $512.86 | Professional | None | $302.00 | $354.81 | $512.86 |
United Setting Facility Modifier None Typical Low $588.84 Median $2,187.76 Typical High $5,888.44 | Facility | None | $588.84 | $2,187.76 | $5,888.44 |
United Setting Professional Modifier None Typical Low $186.21 Median $269.15 Typical High $457.09 | Professional | None | $186.21 | $269.15 | $457.09 |
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 $125.89 Median $144.54 Typical High $181.97 | Professional | 52 · Reduced service | $125.89 | $144.54 | $181.97 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $57.54 Typical High $74.13 | Professional | 53 · Discontinued | $51.29 | $57.54 | $74.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $190.55 Median $218.78 Typical High $275.42 | Professional | 54 · Surgery only | $190.55 | $218.78 | $275.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $43.65 Typical High $54.95 | Professional | 55 · Aftercare only | $38.02 | $43.65 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $28.84 Typical High $36.31 | Professional | 56 · Pre-op care only | $25.70 | $28.84 | $36.31 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $177.83 Median $204.17 Typical High $257.04 | Professional | 78 · Unplanned return to OR | $177.83 | $204.17 | $257.04 |
Where Virginia sits
The same service costs 4.3 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· 34th of 51
$295
AK $933UT $219
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.